Individual provider Active NPI

Jane M Brodwyn, PSY.D

  • Clinical Psychologist
  • Florence, MA
National Provider Identifier
1639279367
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
8406 Issued in MA
Practice address
10 Main St
Florence, MA 01062-3158
Phone
(413) 586-8550
Fax
(413) 586-9765
NPI assigned
Sep 23, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 8406 MA Primary

Addresses

Primary practice location

10 Main St
Florence, MA 01062-3158

Mailing address

10 Main St
Florence, MA 01062-3158
Phone (413) 586-8550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050616000956 MA Practitioner - Clinical Psychologist 1153365499 Practice locations: Northampton, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

224 N St
Northampton, MA 01060-2347
Phone (413) 582-7990

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8406MAMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639279367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 MAIN ST",
            "city": "FLORENCE",
            "state": "MA",
            "postal_code": "010623158",
            "telephone_number": "413-586-8550",
            "fax_number": "413-586-9765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MAIN ST",
            "city": "FLORENCE",
            "state": "MA",
            "postal_code": "010623158",
            "telephone_number": "413-586-8550",
            "fax_number": "413-586-9765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODWYN",
        "first_name": "JANE",
        "middle_name": "M",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "8406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, MA

Sources for this page

Verify at the official NPI Registry.