Active NPI
Marie-Christine Andre, PH.D.
- Clinical Psychologist
- Boston, MA
National Provider Identifier
1679040364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 10935
- Practice address
- 729 Boylston St
Boston, MA 02116-2639 - Phone
- (617) 651-5513
- NPI assigned
- Oct 31, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 10935 | MA | Primary |
| Clinical Psychologist | 103TC0700X | PS1736 | RI |
Addresses
Primary practice location
729 Boylston St
Boston, MA 02116-2639
Mailing address
252 Boston Ave Apt 2
Medford, MA 02155-5227
Phone (954) 558-9558
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10935 | MA | MD | Clinical Psychologist |
| PS1736 | RI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540944000000",
"number": "1679040364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "252 BOSTON AVE APT 2",
"city": "MEDFORD",
"state": "MA",
"postal_code": "021555227",
"telephone_number": "954-558-9558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "729 BOYLSTON ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021162639",
"telephone_number": "617-651-5513"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDRE",
"first_name": "MARIE-CHRISTINE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-10-31",
"last_updated": "2018-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "10935",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "RI",
"license": "PS1736",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.