Individual provider Active NPI

Kristin Nicole Javaras, D.PHIL., PH.D.

  • Clinical Psychologist
  • Belmont, MA
National Provider Identifier
1902258684
Registry record updated Jul 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
10381 Issued in MA
Practice address
115 Mill St
Belmont, MA 02478-1064
Phone
(617) 855-2302
NPI assigned
Jul 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 10381 MA Primary

Addresses

Primary practice location

115 Mill St
Belmont, MA 02478-1064

Mailing address

115 Mill St
Belmont, MA 02478-1064

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
I20180424000483 MA Practitioner - Clinical Psychologist 2961765086 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10381MAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
The McLean Hospital Corporation Clinical CurrentSince Mar 26, 2018 Accepting new patients

Locations

115 Mill St
Stop 117
Belmont, MA 02478
Phone (617) 610-1776

115 Mill St
Belmont, MA 02478
Phone (617) 855-2000

Interoperability endpoints

  • Direct secure messaging: javaras.kristin.mcl@direct.partners.masshiway.net

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1467763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467763200000",
    "number": "1902258684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 MILL ST",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024781064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 MILL ST",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024781064",
            "telephone_number": "617-855-2302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAVARAS",
        "first_name": "KRISTIN",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "D.PHIL., PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-06",
        "last_updated": "2016-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "10381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belmont, MA

Sources for this page

Verify at the official NPI Registry.