Active NPI
Jeffrey Neil Brenner, PH.D.
- Clinical Psychologist
- Auburndale, MA
National Provider Identifier
1760584353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3729
- Practice address
- 355 Lexington St
Auburndale, MA 02466-1211 - Phone
- (617) 332-4121
- NPI assigned
- Sep 2, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3729 | MA | Primary |
Addresses
Primary practice location
355 Lexington St
Auburndale, MA 02466-1211
Mailing address
355 Lexington St
Auburndale, MA 02466-1211
Phone (617) 332-4121
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| W03768 | Other | MA | CLINICAL PSYCHOLOGY |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3729 | MA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1220832000000",
"number": "1760584353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "355 LEXINGTON ST",
"city": "AUBURNDALE",
"state": "MA",
"postal_code": "024661211",
"telephone_number": "617-332-4121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "355 LEXINGTON ST",
"city": "AUBURNDALE",
"state": "MA",
"postal_code": "024661211",
"telephone_number": "617-332-4121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRENNER",
"first_name": "JEFFREY",
"middle_name": "NEIL",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-02",
"last_updated": "2008-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "3729",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLINICAL PSYCHOLOGY",
"identifier": "W03768",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Auburndale, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.