Active NPI
Trevor H. Barese, M.A., M.PHIL., PH.D.
- Clinical Psychologist
- Malden, MA
National Provider Identifier
1649680109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 10501
- Practice address
- 89 Summer St
Malden, MA 02148-2523 - Phone
- (203) 533-1222
- NPI assigned
- May 5, 2014
- Last updated
- May 7, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 10501 | MA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | NU |
Addresses
Primary practice location
89 Summer St
Malden, MA 02148-2523
Mailing address
89 Summer St
Malden, MA 02148-2523
Phone (203) 533-1222
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10501 | MA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525651200000",
"number": "1649680109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "89 SUMMER ST",
"city": "MALDEN",
"state": "MA",
"postal_code": "021482523",
"telephone_number": "203-533-1222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "89 SUMMER ST",
"city": "MALDEN",
"state": "MA",
"postal_code": "021482523",
"telephone_number": "203-533-1222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARESE",
"first_name": "TREVOR",
"middle_name": "H.",
"name_prefix": "Dr.",
"credential": "M.A., M.PHIL., PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-05-05",
"last_updated": "2018-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "10501",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Malden, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.