Individual provider Active NPI

Honor Elizabeth McClellan, PH.D.

  • Counseling Psychologist
  • Brookline, MA
National Provider Identifier
1871534396
Registry record updated Sep 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
1466 Issued in MA
Practice address
1419 Beacon St
Suite 32
Brookline, MA 02446-4808
Phone
(617) 739-2828
Fax
(617) 739-2926
NPI assigned
Jun 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 1466 MA Primary

Addresses

Primary practice location

1419 Beacon St
Suite 32
Brookline, MA 02446-4808

Mailing address

1419 Beacon St
Suite 32
Brookline, MA 02446-4808
Phone (617) 739-2828

Other identifiers 7

IdentifierTypeStateIssuer
8764-01OtherMAHARVARD PILGRIM HEALTH CARE
W01706OtherMABLUESHIELD AND BLUE CROSS
013696OtherMAVALUE OPTIONS
0526959MedicaidMA
701143OtherMATUFTS
051878000OtherMAMAGELLAN
HM2584447OtherMAUNITED BEHAVIORAL HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120328000415 MA Practitioner - Clinical Psychologist 6103083373 Practice locations: Brookline, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1415 Beacon St
Suite 320
Brookline, MA 02446-4812
Phone (617) 584-7550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1466MAMDCounseling Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317254400000",
    "number": "1871534396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1419 BEACON ST",
            "address_2": "SUITE 32",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024464808",
            "telephone_number": "617-739-2828",
            "fax_number": "617-739-2926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1419 BEACON ST",
            "address_2": "SUITE 32",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024464808",
            "telephone_number": "617-739-2828",
            "fax_number": "617-739-2926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLELLAN",
        "first_name": "HONOR",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2011-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MA",
            "license": "1466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTH CARE",
            "identifier": "8764-01",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHIELD AND BLUE CROSS",
            "identifier": "W01706",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "013696",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0526959",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "701143",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "051878000",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHAVIORAL HEALTH",
            "identifier": "HM2584447",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

Verify at the official NPI Registry.