Active NPI
Lisa A Cosgrove, PHD
- Psychologist
- Cambridge, MA
National Provider Identifier
1982199816
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6171-PY-PR
- Practice address
- 415 Broadway
Cambridge, MA 02138-4278 - Phone
- (857) 998-8729
- NPI assigned
- Jun 23, 2018
- Sex
- Female
- 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 | 6171-PY-PR | MA | Primary |
Addresses
Primary practice location
415 Broadway
Cambridge, MA 02138-4278
Mailing address
415 Broadway
Cambridge, MA 02138-4278
Phone (617) 287-7748
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 |
|---|---|---|---|
| 6171-PY-PR | MA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529712000000",
"number": "1982199816",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 BROADWAY",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021384278",
"telephone_number": "617-287-7748"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 BROADWAY",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021384278",
"telephone_number": "857-998-8729"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COSGROVE",
"first_name": "LISA",
"middle_name": "A",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-06-23",
"last_updated": "2018-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "6171-PY-PR",
"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 Jun 23, 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.