Individual provider Active NPI

Thomas Davey, ED.D.

  • Psychologist
  • Boston, MA
National Provider Identifier
1780790709
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
4236 Issued in MA
Practice address
305 Newbury St Ste 42
Boston, MA 02115-2833
Phone
(617) 266-4960
NPI assigned
Aug 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 4236 MA Primary

Addresses

Primary practice location

305 Newbury St Ste 42
Boston, MA 02115-2833

Mailing address

23 Starr LN
Jamaica Plain, MA 02130-2845
Phone (617) 266-4960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 23, 2023 through Feb 23, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
4236MAMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780790709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 STARR LN",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021302845",
            "telephone_number": "617-266-4960",
            "fax_number": "617-266-4960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 NEWBURY ST STE 42",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021152833",
            "telephone_number": "617-266-4960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVEY",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "4236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.