Individual provider Active NPI

Priscilla T. Cheung, PH.D.

  • Clinical Psychologist
  • Boston, MA
National Provider Identifier
1760812069
Registry record updated Apr 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
10202 Issued in MA
Practice address
216 Tremont St FL 2
Boston, MA 02116-4710
Phone
(617) 824-8595
Fax
(617) 824-8909
NPI assigned
Nov 22, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 10202 MA Primary

Addresses

Primary practice location

216 Tremont St FL 2
Boston, MA 02116-4710

Mailing address

216 Tremont St FL 2
Boston, MA 02116-4710
Phone (617) 824-8595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Dec 20, 2023 through Dec 20, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
10202MAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1385078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524528000000",
    "number": "1760812069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 TREMONT ST FL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021164710",
            "telephone_number": "617-824-8595",
            "fax_number": "617-824-8909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 TREMONT ST FL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021164710",
            "telephone_number": "617-824-8595",
            "fax_number": "617-824-8909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEUNG",
        "first_name": "PRISCILLA",
        "middle_name": "T.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-22",
        "last_updated": "2018-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "10202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.