Active NPI
Marci Cloutier, PH.D.
- Clinical Neuropsychologist
- Needham, MA
National Provider Identifier
1710057880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 8635
- Practice address
- 10 Oak St
Needham, MA 02492-2409 - Phone
- (877) 283-7863
- Fax
- (877) 656-4541
- NPI assigned
- Nov 8, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 8635 | MA | Primary |
Addresses
Primary practice location
10 Oak St
Needham, MA 02492-2409
Mailing address
38 W Cedar St
Apt. 2
Boston, MA 02108-1212
Phone (617) 645-7220
Other names 1
- Marci Mrykalo
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 |
|---|---|---|---|
| 8635 | MA | MD | Clinical Neuropsychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710057880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38 W CEDAR ST",
"address_2": "APT. 2",
"city": "BOSTON",
"state": "MA",
"postal_code": "021081212",
"telephone_number": "617-645-7220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 OAK ST",
"city": "NEEDHAM",
"state": "MA",
"postal_code": "024922409",
"telephone_number": "877-283-7863",
"fax_number": "877-656-4541"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLOUTIER",
"first_name": "MARCI",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "MA",
"license": "8635",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARCI",
"last_name": "MRYKALO",
"credential": "PH.D.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Needham, MA
- Alan Edward Clayman, DPM
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- Jennifer Cleary, MS, OTR/L
- Matthew Raymond Clements, LMHC
- Molly Alexandra Cleveland, M.S. CCC-SLP
- Club Management Group (HealthFit)
- Tami A Cobbs
- Christine Cochrane, PT
- Courtney Cogswell, FNP
- Cohen Dermatopathology, P.C. (Inform Diagnostics, Inc)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.