Active NPI
Mark R Dean, PH.D.
- Clinical Psychologist
- Northampton, MA
National Provider Identifier
1821012774
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6085
- Practice address
- 90 Conz St
Suite 220
Northampton, MA 01060-3881 - Phone
- (413) 487-7949
- Fax
- (413) 586-8299
- NPI assigned
- Jul 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6085 | MA | Primary |
Addresses
Primary practice location
90 Conz St
Suite 220
Northampton, MA 01060-3881
Mailing address
PO Box 848
Northampton, MA 01061-0848
Phone (413) 587-7949
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0527076 | Medicaid | MA |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120321000064 | MA | Practitioner - Clinical Psychologist | 8022278555 | Practice locations: Northampton, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
90 Conz St
Suite 220
Northampton, MA 01060-3881
Phone (413) 587-7949
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6085 | MA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1821012774",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 848",
"city": "NORTHAMPTON",
"state": "MA",
"postal_code": "010610848",
"telephone_number": "413-587-7949",
"fax_number": "413-586-8299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "90 CONZ ST",
"address_2": "SUITE 220",
"city": "NORTHAMPTON",
"state": "MA",
"postal_code": "010603881",
"telephone_number": "413-487-7949",
"fax_number": "413-586-8299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEAN",
"first_name": "MARK",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "6085",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0527076",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Northampton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.