Individual provider Active NPI

Elizabeth Hayes Wilson, PSY.D.

  • Clinical Psychologist
  • Dedham, MA
National Provider Identifier
1801947536
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
8511 Issued in MA
Practice address
7 Whitcomb Rd
Dedham, MA 02026-4050
Phone
(508) 472-3116
NPI assigned
Jan 16, 2007
Last updated
Oct 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 8511 MA Primary
Psychologist 103T00000X 8511 MA

Addresses

Primary practice location

7 Whitcomb Rd
Dedham, MA 02026-4050

Mailing address

7 Whitcomb Rd
Dedham, MA 02026-4050
Phone (508) 472-3116

Other identifiers 2

IdentifierTypeStateIssuer
822716000OtherMAMAGELLAN PROVIDER NUMBER
W06480OtherMABCBS PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060123000164 MA Practitioner - Clinical Psychologist 9032132790 Practice locations: Dedham, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1244 Broadway
Unit 5
Raynham, MA 02767-1973

7 Whitcomb Rd
Dedham, MA 02026-4050
Phone (508) 472-3116

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8511MAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1801947536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 WHITCOMB RD",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020264050",
            "telephone_number": "508-472-3116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 WHITCOMB RD",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020264050",
            "telephone_number": "508-472-3116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ELIZABETH",
        "middle_name": "HAYES",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "8511",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "8511",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN PROVIDER NUMBER",
            "identifier": "822716000",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "W06480",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dedham, MA

Sources for this page

Verify at the official NPI Registry.