Active NPI
Amity N Kulis, PSY.D.
- Clinical Neuropsychologist
- Concord, MA
National Provider Identifier
1831244664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 9096
- Practice address
- 30 Monument SQ Ste 212
Concord, MA 01742-1896 - Phone
- (617) 661-1100
- NPI assigned
- Jan 24, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 9096 | MA | |
| Clinical Neuropsychologist | 103G00000X | 9096 | MA | Primary |
Addresses
Primary practice location
30 Monument SQ Ste 212
Concord, MA 01742-1896
Mailing address
30 Monument SQ Ste 212
Concord, MA 01742-1896
Phone (617) 661-1100
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 |
|---|---|---|---|
| 9096 | MA | MD | Clinical Neuropsychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719964800000",
"number": "1831244664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 MONUMENT SQ STE 212",
"city": "CONCORD",
"state": "MA",
"postal_code": "017421896",
"telephone_number": "617-661-1100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 MONUMENT SQ STE 212",
"city": "CONCORD",
"state": "MA",
"postal_code": "017421896",
"telephone_number": "617-661-1100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KULIS",
"first_name": "AMITY",
"middle_name": "N",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-24",
"last_updated": "2024-07-03",
"certification_date": "2024-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "9096",
"primary": false
},
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "MA",
"license": "9096",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.