Individual provider Active NPI

Brenda Gayle Martin-Tousignant, PSY.D.

  • Psychologist
  • Boston, MA
National Provider Identifier
1760818744
Registry record updated Oct 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
11589 Issued in MA
Practice address
112 Water St
Boston, MA 02109-4206
Phone
(617) 315-8856
NPI assigned
Sep 23, 2013
Last updated
Oct 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3843 CT
Psychologist 103T00000X 11589 MA Primary

Addresses

Primary practice location

112 Water St
Boston, MA 02109-4206

Mailing address

189 Birch Bluffs Dr
Westfield, MA 01085-4808
Phone (413) 977-2379

Other practice location 1

105 Spring St
Hartford, CT 06105-2112
Phone (860) 236-4511 ext. 3412

Other names 1

  • Ms. Brenda Gayle Martin Former name

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

LicenseStateTypeSpecialty
3843CTMDPsychologist
11589MAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1379894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1760818744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 BIRCH BLUFFS DR",
            "city": "WESTFIELD",
            "state": "MA",
            "postal_code": "010854808",
            "telephone_number": "413-977-2379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 WATER ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021094206",
            "telephone_number": "617-315-8856"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Spring St",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061052112",
            "country_code": "US",
            "telephone_number": "860-236-4511 x3412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN-TOUSIGNANT",
        "first_name": "BRENDA",
        "middle_name": "GAYLE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-23",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CT",
            "license": "3843",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "11589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENDA",
            "last_name": "MARTIN",
            "middle_name": "GAYLE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Oct 14, 2021; 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.