Individual provider Active NPI

Jessica Laurel Gashin

  • Clinical Psychologist
  • Brookline, MA
National Provider Identifier
1730469586
Registry record updated Apr 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
9645 Issued in MA
Practice address
1731 Beacon St
Unit 1206
Brookline, MA 02445-5350
Phone
(508) 331-6093
NPI assigned
Aug 25, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Psychologist 103TC0700X 9645 MA Primary

Addresses

Primary practice location

1731 Beacon St
Unit 1206
Brookline, MA 02445-5350

Mailing address

1731 Beacon St
Unit 1206
Brookline, MA 02445-5350

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131023000149 MA Practitioner - Clinical Psychologist 7012142359 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9645MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Newton Neuropsychology GP, PLLC Clinical CurrentSince Jul 1, 2021 Accepting new patients

Locations

23 Pleasant St
Newton Centre, MA 02459
Phone (617) 564-0382

199 Wells Ave
Ste 102
Newton Centre, MA 02459
Phone (617) 564-0382

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1314230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430265600000",
    "number": "1730469586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1731 BEACON ST",
            "address_2": "UNIT 1206",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024455350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1731 BEACON ST",
            "address_2": "UNIT 1206",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024455350",
            "telephone_number": "508-331-6093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASHIN",
        "first_name": "JESSICA",
        "middle_name": "LAUREL",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-25",
        "last_updated": "2015-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "9645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

Verify at the official NPI Registry.