Active NPI
Alan Dodge Beck, PH.D.
- Psychologist
- Waban, MA
National Provider Identifier
1912110206
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 569
- Practice address
- 46 Waban Ave
Waban, MA 02468-2143 - Phone
- (617) 525-3572
- Fax
- (617) 527-3573
- NPI assigned
- May 7, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 569 | MA | Primary |
Addresses
Primary practice location
46 Waban Ave
Waban, MA 02468-2143
Mailing address
46 Waban Avenue
Waban, MA 02468
Phone (617) 525-3572
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| W01490 | Other | MA | BLUE CROSS BLUE SHIELD |
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 569 | MA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1912110206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "46 WABAN AVENUE",
"city": "WABAN",
"state": "MA",
"postal_code": "02468",
"telephone_number": "617-525-3572",
"fax_number": "617-527-3573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "46 WABAN AVE",
"city": "WABAN",
"state": "MA",
"postal_code": "024682143",
"telephone_number": "617-525-3572",
"fax_number": "617-527-3573"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BECK",
"first_name": "ALAN",
"middle_name": "DODGE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "569",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "W01490",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waban, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.