Active NPI
Laura Anne Shakun, PSY.D.
- Clinical Psychologist
- Stoneham, MA
National Provider Identifier
1689722399
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 7113
- Practice address
- 271 Main St Ste 205
Stoneham, MA 02180-3580 - Phone
- (781) 438-5550
- Fax
- (781) 438-5553
- NPI assigned
- Jan 8, 2007
- 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 | 7113 | MA | Primary |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 7113 | MA |
Addresses
Primary practice location
271 Main St Ste 205
Stoneham, MA 02180-3580
Mailing address
103 Glen St
Malden, MA 02148-1105
Phone (781) 438-5550
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041110000742 | MA | Practitioner - Clinical Psychologist | 0446213425 | Practice locations: Arlington, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1995
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
Arlington, MA 02474
Phone (781) 757-3060
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7113 | MA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483574400000",
"number": "1689722399",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 GLEN ST",
"city": "MALDEN",
"state": "MA",
"postal_code": "021481105",
"telephone_number": "781-438-5550",
"fax_number": "781-438-5553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "271 MAIN ST STE 205",
"city": "STONEHAM",
"state": "MA",
"postal_code": "021803580",
"telephone_number": "781-438-5550",
"fax_number": "781-438-5553"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAKUN",
"first_name": "LAURA",
"middle_name": "ANNE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-08",
"last_updated": "2017-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "7113",
"primary": true
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "MA",
"license": "7113",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stoneham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.