Active NPI
Paul W. Efthim, PH.D.
- Clinical Psychologist
- Brookline, MA
National Provider Identifier
1831103852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 7306
- Practice address
- 1330 Beacon St Ste 340
Brookline, MA 02446-3203 - Phone
- (617) 734-4644
- NPI assigned
- Jul 27, 2006
- Last updated
- Oct 29, 2021
- 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 | 7306 | MA | Primary |
Addresses
Primary practice location
1330 Beacon St Ste 340
Brookline, MA 02446-3203
Mailing address
1330 Beacon St Ste 340
Brookline, MA 02446-3203
Phone (617) 734-4644
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 1, 2023 through Feb 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635465600000",
"number": "1831103852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1330 BEACON ST STE 340",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024463203",
"telephone_number": "617-734-4644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1330 BEACON ST STE 340",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024463203",
"telephone_number": "617-734-4644"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EFTHIM",
"first_name": "PAUL",
"middle_name": "W.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-27",
"last_updated": "2021-10-29",
"certification_date": "2021-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "7306",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookline, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.