Julia Lacks, PH.D.
Individual provider Active NPI Clinical Psychologist · Westborough, MA
NPI 1720130552 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1720130552
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 7858 (MA)
- Practice address
- 22 Summer St
Westborough, MA 01581-1565 - Phone
- (508) 366-1717
- NPI assigned
- Jan 18, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
22 Summer St
Suite 7
Westborough, MA 01581-1566
Phone (508) 366-1717
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080331000200 | MA | Practitioner - Clinical Psychologist | 5597841692 | Practice locations: Westborough, MA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7858 | MA | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 7858 | MA | Yes |
Addresses
Primary practice location
22 Summer St
Westborough, MA 01581-1565
Mailing address
22 Summer St
Westborough, MA 01581-1565
Phone (508) 366-1717
Other providers in Westborough, MA
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- Mara Lacava
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- Kristen Lagasse
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All providers in Westborough, MA · Clinical Psychologist in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.