NPIMap

Organization Active NPI

Pax Et Bonum Psychological Services, LLC

  • Adult Mental Health Clinic/Center
  • Cambridge, MA
National Provider Identifier
1851814917
Registry record updated Jul 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
10310 Issued in MA
Legal business name
PAX ET BONUM PSYCHOLOGICAL SERVICES, LLC
Practice address
10 Concord Ave
Cambridge, MA 02138-2322
Phone
(617) 515-9902
NPI assigned
Jul 20, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2017

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

Authorized official

Name
Dr. Kristen K Ellard, PH.D.NPI 1679868368
Title
Psychologist/Sole Member
Phone
(617) 515-9902

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X 10310 MA Primary

Addresses

Primary practice location

10 Concord Ave
Cambridge, MA 02138-2322

Mailing address

93 Oxford St # 2
Arlington, MA 02474-6907
Phone (617) 515-9902

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1500508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500508800000",
    "number": "1851814917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 OXFORD ST # 2",
            "city": "ARLINGTON",
            "state": "MA",
            "postal_code": "024746907",
            "telephone_number": "617-515-9902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CONCORD AVE",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021382322",
            "telephone_number": "617-515-9902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAX ET BONUM PSYCHOLOGICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-20",
        "last_updated": "2017-07-20",
        "status": "A",
        "authorized_official_last_name": "ELLARD",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PSYCHOLOGIST/SOLE MEMBER",
        "authorized_official_telephone_number": "617-515-9902",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "MA",
            "license": "10310",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 20, 2017; 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.