Individual provider Active NPI

Evan Alexander Dahlstedt

  • Developmental Therapist
  • Danvers, MA
National Provider Identifier
1851647267
Registry record updated Aug 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
Practice address
6 Southside Rd
Danvers, MA 01923-1409
Phone
(978) 762-8352
NPI assigned
Aug 3, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X Primary

Addresses

Primary practice location

6 Southside Rd
Danvers, MA 01923-1409

Mailing address

6 Southside Rd
Danvers, MA 01923-1409
Phone (978) 762-8352

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Undefined Non-Physician Type (Specify)
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1340 Boylston St
Boston, MA 02215-4302

75 Federal St FL
Suite 7
Boston, MA 02110-1913

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1343952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343952000000",
    "number": "1851647267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 SOUTHSIDE RD",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019231409",
            "telephone_number": "978-762-8352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 SOUTHSIDE RD",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019231409",
            "telephone_number": "978-762-8352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHLSTEDT",
        "first_name": "EVAN",
        "middle_name": "ALEXANDER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-03",
        "last_updated": "2012-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danvers, MA

Sources for this page

Verify at the official NPI Registry.