Active NPI
Thomas John Deters, PHD
- Forensic Psychologist
- Cambridge, MA
National Provider Identifier
1851376578
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Forensic Psychologist
- License
- 3637
- Practice address
- 1753 Massachusetts Ave
Cambridge, MA 02140-2231 - Phone
- (617) 661-7516
- Fax
- (617) 661-7516
- NPI assigned
- Dec 15, 2005
- 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 3637 | MA | |
| Psychologist | 103T00000X | 353 | NH | |
| Clinical Neuropsychologist | 103G00000X | 3637 | MA | |
| Clinical Psychologist | 103TC0700X | 3637 | MA | |
| Forensic Psychologist | 103TF0200X | 3637 | MA | Primary |
Addresses
Primary practice location
1753 Massachusetts Ave
Cambridge, MA 02140-2231
Mailing address
61 Garfield St Apt 16
Cambridge, MA 02138-1865
Phone (617) 661-7516
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| W03667 | Other | BCBS |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 353 | NH | MD | Psychologist |
| 3637 | MA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1851376578",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "61 GARFIELD ST APT 16",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021381865",
"telephone_number": "617-661-7516",
"fax_number": "617-661-7516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1753 MASSACHUSETTS AVE",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021402231",
"telephone_number": "617-661-7516",
"fax_number": "617-661-7516"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DETERS",
"first_name": "THOMAS",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-12-15",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "3637",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NH",
"license": "353",
"primary": false
},
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "MA",
"license": "3637",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "3637",
"primary": false
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "MA",
"license": "3637",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "W03667",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.