Active NPI
Helena Yolanda Stauber, ED.D.
- Psychologist
- Lexington, MA
National Provider Identifier
1669538146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 7075
- Practice address
- 4 Militia Dr
Suite 23
Lexington, MA 02421-4737 - Phone
- (617) 513-1775
- NPI assigned
- Dec 28, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 7075 | MA | Primary |
Addresses
Primary practice location
4 Militia Dr
Suite 23
Lexington, MA 02421-4737
Mailing address
118 Wyman Rd
Billerica, MA 01821-3740
Phone (617) 513-1775
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| W05711 | Other | MA | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 15, 2024 through Apr 15, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7075 | MA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1669538146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "118 WYMAN RD",
"city": "BILLERICA",
"state": "MA",
"postal_code": "018213740",
"telephone_number": "617-513-1775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 MILITIA DR",
"address_2": "SUITE 23",
"city": "LEXINGTON",
"state": "MA",
"postal_code": "024214737",
"telephone_number": "617-513-1775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAUBER",
"first_name": "HELENA",
"middle_name": "YOLANDA",
"name_prefix": "Dr.",
"credential": "ED.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "7075",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "W05711",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lexington, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.