Individual provider Active NPI

Carole Flynn, M.ED

  • Developmental Therapist
  • Marlborough, MA
National Provider Identifier
1700064987
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
License
0279986 Issued in MA
Practice address
532 Williams St
Marlborough, MA 01752-6049
Phone
(508) 733-1562
NPI assigned
Feb 10, 2008
Last updated
Aug 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU
Developmental Therapist 222Q00000X 0279986 MA Primary

Addresses

Primary practice location

532 Williams St
Marlborough, MA 01752-6049

Mailing address

320 W 38TH St Apt 1925
New York, NY 10018-5255
Phone (150) 873-3156

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
Master of Education

State licenses

LicenseStateTypeSpecialty
0279986MAMDDevelopmental Therapist

NPI Registry JSON

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

{
    "created_epoch": "1202601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1700064987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 W 38TH ST APT 1925",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100185255",
            "telephone_number": "150-873-3156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "532 WILLIAMS ST",
            "city": "MARLBOROUGH",
            "state": "MA",
            "postal_code": "017526049",
            "telephone_number": "508-733-1562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLYNN",
        "first_name": "CAROLE",
        "name_prefix": "Mrs.",
        "credential": "M.ED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-10",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "MA",
            "license": "0279986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlborough, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; 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.