Rose Pendala Andrejczyk, PSY.D
Individual provider Active NPI Psychologist · South Hadley, MA
NPI 1760636385 · NPPES record last updated Nov 10, 2008
Key facts
- NPI
- 1760636385
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- Practice address
- 20 New Ludlow Rd
South Hadley, MA 01075-3002 - Phone
- (413) 536-1958
- NPI assigned
- Nov 10, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Supportive Behavioral Care of Mass LLC
Supportive Behavioral Care of Ma LLC
Practice addresses (Care Compare)
120 S Main St
Centerville, MA 02632-3246
Phone (718) 506-1115
44 School St
RM 325
Boston, MA 02108-4209
Phone (718) 298-4375
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100423000362 | MA | Practitioner - Clinical Psychologist | 8022144393 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9005 | MA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Supportive Behavioral Care of Mass LLC | Psychologist | Current |
Accepting new patients |
| River Valley Counseling Center, Inc | Current |
Accepting new patients | |
| Supportive Behavioral Care of Ma LLC | Current |
Accepting new patients | |
| River Valley Counseling Center, Inc | Past |
Accepting new patients |
Locations
44 School St
Rm 325
Boston, MA 02108
Phone (508) 831-8558
2 Beaumont Ave
Brockton, MA 02302
Phone (508) 588-8500
8 Lewis Point Rd
Buzzards Bay, MA 02532
Phone (508) 743-8120
120 S Main St
Centerville, MA 02632
Phone (508) 775-1835
303 Beech St
Holyoke, MA 01040
Phone (413) 540-1155
11 North St
Stoneham, MA 02180
Phone (603) 759-4559
27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/rvccinc/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | Yes |
Addresses
Primary practice location
20 New Ludlow Rd
South Hadley, MA 01075-3002
Mailing address
20 New Ludlow Rd
South Hadley, MA 01075-3002
Phone (413) 536-1958
Other providers in South Hadley, MA
- Patricia Alford
- Cassandra C Allard
- Alternative Evaluations and Behavioral Consultations LLC
- Nicole Ann Amrani
- Rebecca G Anderson
- Yinia Arce'
- Lauren E. Arcibal
- Paula M Arends
- Kathleen J Arnold
- Elizabeth Gallup Atkins
All providers in South Hadley, MA · Psychologist in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 10, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.