Active NPI
Meghan Van Keuren
- Clinical Psychologist
- Woburn, MA
National Provider Identifier
1811297088
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 10097
- Practice address
- 12 Alfred St
Woburn, MA 01801-1972 - Phone
- (781) 646-0500
- Fax
- (781) 646-7130
- NPI assigned
- Oct 22, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 000007496 | MA | |
| Clinical Psychologist | 103TC0700X | 10097 | MA | Primary |
Addresses
Primary practice location
12 Alfred St
Woburn, MA 01801-1972
Mailing address
12 Alfred St Ste 200
Woburn, MA 01801-1915
Phone (781) 646-0500
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
| License | State | Type | Specialty |
|---|---|---|---|
| 000007496 | MA | MD | Professional Counselor |
| 10097 | MA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426550400000",
"number": "1811297088",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 ALFRED ST STE 200",
"city": "WOBURN",
"state": "MA",
"postal_code": "018011915",
"telephone_number": "781-646-0500",
"fax_number": "781-646-7130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 ALFRED ST",
"city": "WOBURN",
"state": "MA",
"postal_code": "018011972",
"telephone_number": "781-646-0500",
"fax_number": "781-646-7130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN KEUREN",
"first_name": "MEGHAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-22",
"last_updated": "2015-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MA",
"license": "000007496",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "10097",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woburn, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.