NPIMap

Organization Active NPI

S. Ebrahimi-Keshishian, PH.D., PC

  • Clinical Psychologist
  • Cambridge, MA
National Provider Identifier
1760609549
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6214 Issued in MA
Legal business name
S. EBRAHIMI-KESHISHIAN, PH.D., PC
Practice address
3 Bow St
Cambridge, MA 02138-5103
Phone
(617) 547-8764
NPI assigned
Apr 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Seda Ebrahimi-Keshishian, PH.D.
Title
Director
Phone
(617) 547-8764

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 6214 MA Primary

Addresses

Primary practice location

3 Bow St
Cambridge, MA 02138-5103

Mailing address

3 Bow St
Cambridge, MA 02138-5103
Phone (617) 547-8764

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760609549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 BOW ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021385103",
            "telephone_number": "617-547-8764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 BOW ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021385103",
            "telephone_number": "617-547-8764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S. EBRAHIMI-KESHISHIAN, PH.D., PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EBRAHIMI-KESHISHIAN",
        "authorized_official_first_name": "SEDA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "617-547-8764",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "6214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.