NPIMap

Organization Active NPI

Brandeis University

  • Psychologist
  • Waltham, MA
National Provider Identifier
1669689014
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
BRANDEIS UNIVERSITY
Practice address
Ms 061, 415 South St
Waltham, MA 02454-9110
Phone
(781) 736-3730
Fax
(781) 736-3731
NPI assigned
May 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Robert Y. Berlin, PH.D.
Title
Director
Phone
(781) 736-3730

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X
Counseling PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC1900X
Prescribing (Medical) PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TP0016X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X

Addresses

Primary practice location

Ms 061, 415 South St
Waltham, MA 02454-9110

Mailing address

Ms 061, 415 South St
P.O. Box 549110
Waltham, MA 02454-9110
Phone (781) 736-3730

Other names 1

  • Brandeis University Psychological Counseling Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Brandeis University3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1669689014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MS 061, 415 SOUTH ST",
            "address_2": "P.O. BOX 549110",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024549110",
            "telephone_number": "781-736-3730",
            "fax_number": "781-736-3731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MS 061, 415 SOUTH ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024549110",
            "telephone_number": "781-736-3730",
            "fax_number": "781-736-3731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANDEIS UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "BERLIN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "Y.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "781-736-3730",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TP0016X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brandeis University Psychological Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waltham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.