Individual provider Active NPI

Linda Louise Faldetta, PH.D.

  • Psychologist
  • Medford, MA
National Provider Identifier
1942799556
Registry record updated May 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6473-PY-PY Issued in MA
Practice address
2 Gleason St
Medford, MA 02155-2223
Phone
(781) 396-8791
NPI assigned
May 9, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6473-PY-PY MA Primary

Addresses

Primary practice location

2 Gleason St
Medford, MA 02155-2223

Mailing address

2 Gleason St
Medford, MA 02155-2223
Phone (781) 396-8791

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

LicenseStateTypeSpecialty
6473-PY-PYMAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1525824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525824000000",
    "number": "1942799556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 GLEASON ST",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021552223",
            "telephone_number": "781-396-8791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 GLEASON ST",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021552223",
            "telephone_number": "781-396-8791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALDETTA",
        "first_name": "LINDA",
        "middle_name": "LOUISE",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-09",
        "last_updated": "2018-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "6473-PY-PY",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2018; 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.