Lifedimensions Neuropsychological Services, Inc

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

LIFEDIMENSIONS NEUROPSYCHOLOGICAL SERVICES, INC

Practice address

250 Pond St
Lifedimensions Neuropsychological Services, Inc.
Braintree, MA 02184-5351

Phone

(781) 348-2258

Fax

(781) 348-2132

NPI assigned

Feb 12, 2006

Last updated

Mar 19, 2011By the provider in NPPES

Organization subpart

Yes

Parent organization

LIFEDIMENSIONS NEUROPSYCHOLOGICAL SERVICES, INCAs reported in NPPES

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

Authorized official

Name

Dr. Marie M Walbridge, PH.D.

Title

Clerk, Co-Owner

Phone

(781) 348-3900

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• LIfeSpan Services, Inc. or Lifespan Neuropsychological Services, Inc. Former legal business name

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Part of

Lifedimensions Neuropsychological Services Inc

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ashita Shyam Gurnani, PHD

  • Clinical Neuropsychologist
  • Braintree, MA
  • NPI 1831703107
  Medicare reassignment Care Compare group NPD
• Nicole Sommerich, PSYD

  • Mental Health Counselor
  • Braintree, MA
  • NPI 1568129542
  Medicare reassignment Care Compare group NPD
• Anne Marie Lasoski, PSY.D.

  • Clinical Neuropsychologist
  • Braintree, MA
  • NPI 1992859953
  NPD

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

{
    "created_epoch": "1139702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300492800000",
    "number": "1932172632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 POND ST",
            "address_2": "LIFEDIMENSIONS NEUROPSYCHOLOGICAL SERVICES, INC.",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021845351",
            "telephone_number": "781-348-2258",
            "fax_number": "781-348-2132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 POND ST",
            "address_2": "LIFEDIMENSIONS NEUROPSYCHOLOGICAL SERVICES, INC.",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021845351",
            "telephone_number": "781-348-2258",
            "fax_number": "781-348-2132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEDIMENSIONS NEUROPSYCHOLOGICAL SERVICES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIFEDIMENSIONS NEUROPSYCHOLOGICAL SERVICES, INC",
        "enumeration_date": "2006-02-12",
        "last_updated": "2011-03-19",
        "status": "A",
        "authorized_official_last_name": "WALBRIDGE",
        "authorized_official_first_name": "MARIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CLERK, CO-OWNER",
        "authorized_official_telephone_number": "781-348-3900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MA",
            "license": "4712",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9721771",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "W10469",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LIfeSpan Services, Inc. or Lifespan Neuropsychological Services, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Yamini S Levitzky, M.D.
• Lian Li, RPH
• Siqi Li
• Rebecca Lieberson
• Life Qi Holistic Medicine LLC
• Max Zlochower Linzer
• LM Dental LLC (mass dental preventive care)
• Mark Logan, D.C.
• Marsha Logan, DC
• Shealyn Lonergan

• Psychologist in Braintree, MA
• Providers in Braintree, MA by specialty
• Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.