Clara A Logan, EDM

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

12089 Issued in MA

Practice address

10I Roessler Rd
Woburn, MA 01801-6208

Phone

(781) 932-8114

NPI assigned

Sep 17, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1537142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1891279808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 OAK ST",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018803833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10I ROESSLER RD",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018016208",
            "telephone_number": "781-932-8114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1115 W Chestnut St",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023017501",
            "country_code": "US",
            "telephone_number": "508-521-2200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "CLARA",
        "middle_name": "A",
        "credential": "EDM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-17",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "12089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Lockney, PT, DPT
• Lysha Lockwood, PTA
• Nina Loconto, PTA
• Melissa Loeb, SLP
• Rebecca Loeb
• Heidi Falk Logan, LICSW
• Ashley Loh, OTD, OTR
• Kristen Lombardelli, BCBA
• Ellen Lisa London, MSED
• Laurie Long, COTA

• Mental Health Counselor in Woburn, MA
• Providers in Woburn, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; 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.