Individual provider Active NPI

Jennifer A Dotson, PSY.D.

  • Clinical Psychologist
  • Boston, MA
National Provider Identifier
1881801702
Registry record updated Mar 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
9348 Issued in MA
Practice address
896 Beacon St # 204
Boston, MA 02215-3033
Phone
(617) 447-0378
Fax
(617) 701-7674
NPI assigned
May 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Psychologist 103TC0700X 9348 MA Primary

Addresses

Primary practice location

896 Beacon St # 204
Boston, MA 02215-3033

Mailing address

896 Beacon St # 204
Boston, MA 02215-3033
Phone (617) 447-0378

Other practice location 1

14 Ardale St
Roslindale, MA 02131-1506
Phone (857) 939-0472

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

State licenses

LicenseStateTypeSpecialty
9348MAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551830400000",
    "number": "1881801702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "896 BEACON ST # 204",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022153033",
            "telephone_number": "617-447-0378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "896 BEACON ST # 204",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022153033",
            "telephone_number": "617-447-0378",
            "fax_number": "617-701-7674"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 Ardale St",
            "address_purpose": "LOCATION",
            "city": "Roslindale",
            "state": "MA",
            "postal_code": "021311506",
            "country_code": "US",
            "telephone_number": "857-939-0472",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOTSON",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2019-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "9348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2019; 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.