Active NPI
Megan Elizabeth Stake, MA
- Developmental Therapist
- Woburn, MA
National Provider Identifier
1881039964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- License
- S81557183
- Practice address
- 10J Gill St
Woburn, MA 01801-1721 - Phone
- (781) 932-2888
- NPI assigned
- May 2, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | S81557183 | MA | Primary |
Addresses
Primary practice location
10J Gill St
Woburn, MA 01801-1721
Mailing address
87 Bartlett St Apt 3
Somerville, MA 02145-2611
Phone (774) 275-1079
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)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S81557183 | MA | MD | Developmental Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367452800000",
"number": "1881039964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "87 BARTLETT ST APT 3",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "021452611",
"telephone_number": "774-275-1079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10J GILL ST",
"city": "WOBURN",
"state": "MA",
"postal_code": "018011721",
"telephone_number": "781-932-2888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAKE",
"first_name": "MEGAN",
"middle_name": "ELIZABETH",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-05-02",
"last_updated": "2013-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": "MA",
"license": "S81557183",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woburn, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.