Active NPI
Roberta Chandler Wegner, PSY.D.
- Clinical Psychologist
- Brookline, MA
National Provider Identifier
1861720088
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 9126
- Practice address
- 1371 Beacon St
Suite 304
Brookline, MA 02446-4905 - Phone
- (617) 232-2437
- NPI assigned
- Nov 29, 2009
- 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 | 9126 | MA | Primary |
| Clinical Psychologist | 103TC0700X | 018307 | NY |
Addresses
Primary practice location
1371 Beacon St
Suite 304
Brookline, MA 02446-4905
Mailing address
1371 Beacon St
Suite 304
Brookline, MA 02446-4905
Phone (617) 232-2437
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 |
|---|---|---|---|
| 018307 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1259452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1259884800000",
"number": "1861720088",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1371 BEACON ST",
"address_2": "SUITE 304",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024464905",
"telephone_number": "617-232-2437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1371 BEACON ST",
"address_2": "SUITE 304",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024464905",
"telephone_number": "617-232-2437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEGNER",
"first_name": "ROBERTA",
"middle_name": "CHANDLER",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-11-29",
"last_updated": "2009-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "9126",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "018307",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookline, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.