Individual provider Active NPI

Colleen Jane O'Brien

  • Clinical Psychologist
  • Cambridge, MA
National Provider Identifier
1942427992
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6481 Issued in MA
Practice address
240 Concord Ave
Suite 2
Cambridge, MA 02138-1337
Phone
(781) 572-6869
NPI assigned
Apr 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 6481 MA Primary

Addresses

Primary practice location

240 Concord Ave
Suite 2
Cambridge, MA 02138-1337

Mailing address

240 Concord Ave
Suite 2
Cambridge, MA 02138-1337
Phone (781) 572-6869

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6481MAMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Cambridge Public Health Commission Current Accepting new patients

Locations

1493 Cambridge St
Cambridge, MA 02139
Phone (617) 665-1185

350 Main St
Ste 31
Malden, MA 02148
Phone (781) 397-6583

Interoperability endpoints

  • Direct secure messaging: cobrien34585@direct.challiance.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": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942427992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 CONCORD AVE",
            "address_2": "SUITE 2",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021381337",
            "telephone_number": "781-572-6869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 CONCORD AVE",
            "address_2": "SUITE 2",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021381337",
            "telephone_number": "781-572-6869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "COLLEEN",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "6481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, 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.

Verify at the official NPI Registry.