Individual provider Active NPI

Debika Paul, PH.D.

  • Clinical Psychologist
  • Worcester, MA
National Provider Identifier
1962514174
Registry record updated Dec 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
9042 Issued in MA
Practice address
72 Jaques Ave
Worcester, MA 01610-2476
Phone
(508) 421-4529
NPI assigned
Sep 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2009

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 9042 MA Primary

Addresses

Primary practice location

72 Jaques Ave
Worcester, MA 01610-2476

Mailing address

72 Jaques Ave
Worcester, MA 01610-2476
Phone (508) 421-4529

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
I20100303000156 MA Practitioner - Clinical Psychologist 6406991363 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Commonwealth of MassachusettsGroup PAC ID 8820906860, 141 clinicians

Practice addresses (Care Compare)

309 Belmont St
Worcester, MA 01604-1059
Phone (508) 368-0704

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9042MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Commonwealth of Massachusetts CurrentSince Mar 29, 2018 Accepting new patients
Community Healthlink, Inc. CurrentSince Dec 16, 2009 Accepting new patients
Community Healthlink Inc Current Accepting new patients
The Commonwealth of Massachusetts CurrentSince Mar 29, 2018 Accepting new patients

Locations

40 Spruce St
#2
Leominster, MA 01453
Phone (978) 534-6116

72 Jaques Ave
Worcester, MA 01610
Phone (508) 860-1154

Organizations & group practices 4

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": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259798400000",
    "number": "1962514174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 JAQUES AVE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016102476",
            "telephone_number": "508-421-4529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 JAQUES AVE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016102476",
            "telephone_number": "508-421-4529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUL",
        "first_name": "DEBIKA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2009-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "9042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.