NPIMap

Individual provider Active NPI

Renee M Nelson, PSY.D.

  • Clinical Psychologist
  • Holden, MA
National Provider Identifier
1679725907
Registry record updated Feb 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
9464 Issued in MA
Practice address
788 Main St
2ND Floor
Holden, MA 01520-1863
Phone
(978) 853-6175
NPI assigned
Oct 17, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 9464 MA Primary

Addresses

Primary practice location

788 Main St
2ND Floor
Holden, MA 01520-1863

Mailing address

788 Main St
2ND Floor
Holden, MA 01520-1863
Phone (978) 853-6175

Other names 1

  • Dr. Renee M Bazinet Nelson Professional name

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

State licenses

LicenseStateTypeSpecialty
9464MAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1224201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424649600000",
    "number": "1679725907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "788 MAIN ST",
            "address_2": "2ND FLOOR",
            "city": "HOLDEN",
            "state": "MA",
            "postal_code": "015201863",
            "telephone_number": "978-853-6175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "788 MAIN ST",
            "address_2": "2ND FLOOR",
            "city": "HOLDEN",
            "state": "MA",
            "postal_code": "015201863",
            "telephone_number": "978-853-6175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "RENEE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-17",
        "last_updated": "2015-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "9464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENEE",
            "last_name": "BAZINET NELSON",
            "middle_name": "M",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Holden, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2015; 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.