Active NPI
Kevin Brailey, PH.D.
- Clinical Psychologist
- Boston, MA
National Provider Identifier
1720188840
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 706
- Practice address
- 150 S Huntington Ave
Psychology Service (116B)
Boston, MA 02130-4817 - Phone
- (857) 364-6519
- NPI assigned
- Sep 25, 2006
- Sex
- Male
- 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 | 706 | LA | Primary |
| VA Clinic/Center | 261QV0200X | 706 | LA |
Addresses
Primary practice location
150 S Huntington Ave
Psychology Service (116B)
Boston, MA 02130-4817
Mailing address
150 S Huntington Ave
Psychology Service (116B)
Boston, MA 02130-4817
Phone (857) 364-6519
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 |
|---|---|---|---|
| 706 | LA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491091200000",
"number": "1720188840",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 S HUNTINGTON AVE",
"address_2": "PSYCHOLOGY SERVICE (116B)",
"city": "BOSTON",
"state": "MA",
"postal_code": "021304817",
"telephone_number": "857-364-6519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 S HUNTINGTON AVE",
"address_2": "PSYCHOLOGY SERVICE (116B)",
"city": "BOSTON",
"state": "MA",
"postal_code": "021304817",
"telephone_number": "857-364-6519"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAILEY",
"first_name": "KEVIN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-25",
"last_updated": "2017-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "LA",
"license": "706",
"primary": true
},
{
"code": "261QV0200X",
"taxonomy_group": "",
"desc": "Clinic/Center, VA",
"state": "LA",
"license": "706",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.