Active NPI
Anja Marina Ullrich, PH.D
- Clinical Psychologist
- Hingham, MA
National Provider Identifier
1720398316
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 9222
- Practice address
- 62 Derby St Ste 6
Hingham, MA 02043-3718 - Phone
- (671) 791-1403
- NPI assigned
- Oct 15, 2010
- Last updated
- Apr 13, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 Psychologist | 103TC0700X | 9222 | MA | Primary |
Addresses
Primary practice location
62 Derby St Ste 6
Hingham, MA 02043-3718
Mailing address
62 Derby St Ste 6
Hingham, MA 02043-3718
Phone (671) 791-1403
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110128000590 | MA | Practitioner - Clinical Psychologist | 1951580463 | Practice locations: Scituate, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
146 Front St
Scituate, MA 02066-1336
Phone (617) 791-1403
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555113600000",
"number": "1720398316",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "62 DERBY ST STE 6",
"city": "HINGHAM",
"state": "MA",
"postal_code": "020433718",
"telephone_number": "671-791-1403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "62 DERBY ST STE 6",
"city": "HINGHAM",
"state": "MA",
"postal_code": "020433718",
"telephone_number": "671-791-1403"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ULLRICH",
"first_name": "ANJA",
"middle_name": "MARINA",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-10-15",
"last_updated": "2019-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "9222",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hingham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.