Individual provider Active NPI

John Douglas Fletcher, ED.D

  • Counseling Psychologist
  • Newton, MA
National Provider Identifier
1659582138
Registry record updated Jun 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Practice address
56 Wildwood Ave
Newton, MA 02460-1322
Phone
(617) 782-6460
Fax
(617) 782-6457
NPI assigned
May 25, 2007
Last updated
Jun 17, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X Primary
Counselor 101Y00000X

Addresses

Primary practice location

56 Wildwood Ave
Newton, MA 02460-1322

Mailing address

797 Washington St
Ste 3
Newton, MA 02460-1634
Phone (617) 782-6460

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
I20180402000536 MA Practitioner - Clinical Psychologist 2567374473 Practice locations: Newton, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

56 Wildwood Ave
Newton, MA 02460-1322
Phone (617) 959-0149

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1659582138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "797 WASHINGTON ST",
            "address_2": "STE 3",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024601634",
            "telephone_number": "617-782-6460",
            "fax_number": "617-782-6457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 WILDWOOD AVE",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024601322",
            "telephone_number": "617-782-6460",
            "fax_number": "617-782-6457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "JOHN",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "ED.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-25",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, MA

Sources for this page

Verify at the official NPI Registry.