NPIMap

Organization Active NPI

M. Gorman Psychological Associates Inc

  • Psychologist
  • Newton, MA
National Provider Identifier
1710056486
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
M. GORMAN PSYCHOLOGICAL ASSOCIATES INC
Practice address
One Wells Ave
Fourth Floor
Newton, MA 02459
Phone
(617) 327-6777
Fax
(617) 323-6969
NPI assigned
Nov 7, 2006
Last updated
Sep 26, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Authorized official

Name
Dr. Kelly Casey, PHD
Title
Executive Director, Brenner Assessm
Phone
(617) 327-6777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X MA Primary

Addresses

Primary practice location

One Wells Ave
Fourth Floor
Newton, MA 02459

Mailing address

One Wells Ave
Fourth Floor
Newton, MA 02459
Phone (617) 327-6777

Other identifiers 1

IdentifierTypeStateIssuer
9762761MedicaidMA

National Provider Directory

National Provider Directory

Locations

1 Wells Ave
Fl 4
Newton, MA 02459
Phone (617) 327-6777

1208 Vfw Pkwy
Ste 300
West Roxbury, MA 02132
Phone (617) 323-1735

221 Rivermoor St
West Roxbury, MA 02132
Phone (617) 323-1735

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695686400000",
    "number": "1710056486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE WELLS AVE",
            "address_2": "FOURTH FLOOR",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "02459",
            "telephone_number": "617-327-6777",
            "fax_number": "617-323-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE WELLS AVE",
            "address_2": "FOURTH FLOOR",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "02459",
            "telephone_number": "617-327-6777",
            "fax_number": "617-323-6969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M. GORMAN PSYCHOLOGICAL ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2023-09-26",
        "status": "A",
        "authorized_official_last_name": "CASEY",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR, BRENNER ASSESSM",
        "authorized_official_telephone_number": "617-327-6777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9762761",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.