Organization Active NPI

MD Psychology LLC

  • Clinical Psychologist
  • North Easton, MA
National Provider Identifier
1720464753
Registry record updated May 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
278285 Issued in MA
Legal business name
MD PSYCHOLOGY LLC
Practice address
115 Main St
Suite 2a
North Easton, MA 02356-1409
Phone
(508) 456-6287
Fax
(844) 766-2013
NPI assigned
Jul 31, 2015
Last updated
May 17, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2021

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

Authorized official

Name
Maggie Naughton
Title
Office Manager
Phone
(507) 297-0863

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 278285 MA Primary

Addresses

Primary practice location

115 Main St
Suite 2a
North Easton, MA 02356-1409

Mailing address

115 Main St
Suite 2a
North Easton, MA 02356-1409
Phone (508) 456-6287

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161018001268 MA Part B Supplier - Clinic/Group Practice 4486942844 Receives reassigned benefits from 1 practitioner
Practice locations: North Easton, MA

National Provider Directory

National Provider Directory

Locations

100 Main St
North Easton, MA 02356
Phone (508) 238-1360

115 Main St
Ste 2A
North Easton, MA 02356
Phone (508) 297-0863

Practitioners & affiliated clinicians

Practitioners 1

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": "1438300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621209600000",
    "number": "1720464753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 MAIN ST",
            "address_2": "SUITE 2A",
            "city": "NORTH EASTON",
            "state": "MA",
            "postal_code": "023561409",
            "telephone_number": "508-456-6287",
            "fax_number": "844-766-2013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 MAIN ST",
            "address_2": "SUITE 2A",
            "city": "NORTH EASTON",
            "state": "MA",
            "postal_code": "023561409",
            "telephone_number": "508-456-6287",
            "fax_number": "844-766-2013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MD PSYCHOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-31",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A",
        "authorized_official_last_name": "NAUGHTON",
        "authorized_official_first_name": "MAGGIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "507-297-0863"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "278285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Easton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.