Active NPI
Krissandra Janine Lyons-Robinson
- Adolescent and Children Mental Health Clinic/Center
- Boston, MA
National Provider Identifier
1740971829
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adolescent and Children Mental Health Clinic/Center
- License
- 228008
- Practice address
- 520 Dudley St
Boston, MA 02119-2769 - Phone
- (617) 821-6077
- NPI assigned
- May 18, 2023
- 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 |
|---|---|---|---|---|
| Adolescent and Children Mental Health Clinic/Center | 261QM0855X | 228008 | MA | Primary |
Addresses
Primary practice location
520 Dudley St
Boston, MA 02119-2769
Mailing address
520 Dudley St
Boston, MA 02119-2769
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 228008 | MA | MD | MOHS-Micrographic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684368000000",
"number": "1740971829",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "520 DUDLEY ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021192769"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 DUDLEY ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021192769",
"telephone_number": "617-821-6077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYONS-ROBINSON",
"first_name": "KRISSANDRA",
"middle_name": "JANINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-05-18",
"last_updated": "2023-05-18",
"certification_date": "2023-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "261QM0855X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adolescent and Children Mental Health",
"state": "MA",
"license": "228008",
"primary": true
}
],
"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 May 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.