Village Psychology PLLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

VILLAGE PSYCHOLOGY PLLC

Practice address

9 Chandler St
Watertown, MA 02472-1008

Phone

(617) 855-9204

NPI assigned

Sep 12, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Jaclyn Wolfman, PHDNPI 1366850661

Title

Owner

Phone

(617) 855-9204

Specialties & licenses 10

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jaclyn Wolfman, PHD

  • Psychologist
  • Belmont, MA
  • NPI 1366850661
  NPD Authorized official

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

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    "created_epoch": "1694476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694476800000",
    "number": "1851178966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 CHANDLER ST",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024721008",
            "telephone_number": "617-855-9204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 CHANDLER ST",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024721008",
            "telephone_number": "617-855-9204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE PSYCHOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-12",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A",
        "authorized_official_last_name": "WOLFMAN",
        "authorized_official_first_name": "JACLYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-855-9204",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Watertown, MA
• Providers in Watertown, MA by specialty
• Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.