Organization Active NPI

Cranberry Counseling Professional Corporation

  • Clinical Psychologist
  • Weymouth, MA
National Provider Identifier
1659506228
Registry record updated Feb 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3821 Issued in MA
Legal business name
CRANBERRY COUNSELING PROFESSIONAL CORPORATION
Practice address
210 Winter St Ste 303
Weymouth, MA 02188-3336
Phone
(781) 837-5344
Fax
(781) 803-2728
NPI assigned
May 26, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2025

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

Authorized official

Name
Terry Alan Hayes, PH.D.NPI 1962495226
Title
President
Phone
(781) 837-5344

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 3821 MA Primary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X

Addresses

Primary practice location

210 Winter St Ste 303
Weymouth, MA 02188-3336

Mailing address

210 Winter St Ste 303
Weymouth, MA 02188-3336
Phone (781) 837-5344

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090901000204 MA Part B Supplier - Clinic/Group Practice 5496800245 Receives reassigned benefits from 1 practitioner
Practice locations: Weymouth, MA

National Provider Directory

National Provider Directory

Locations

769 Plain St
Ste B
Marshfield, MA 02050
Phone (781) 837-5344

210 Winter St
Ste 303
Weymouth, MA 02188
Phone (781) 837-5344

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1243296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738886400000",
    "number": "1659506228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 WINTER ST STE 303",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021883336",
            "telephone_number": "781-837-5344",
            "fax_number": "781-803-2728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 WINTER ST STE 303",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021883336",
            "telephone_number": "781-837-5344",
            "fax_number": "781-803-2728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRANBERRY COUNSELING PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-26",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-837-5344",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "3821",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weymouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.