Active NPI
Alexis Vichniac
- School Psychologist
- Somerville, MA
National Provider Identifier
1982987020
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 442207 7335
- Practice address
- 163 Elm St
3
Somerville, MA 02144-3110 - Phone
- (617) 571-8058
- NPI assigned
- Sep 26, 2011
- 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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 442207 7335 | MA | Primary |
Addresses
Primary practice location
163 Elm St
3
Somerville, MA 02144-3110
Mailing address
163 Elm St
3
Somerville, MA 02144-3110
Phone (617) 571-8058
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 442207 7335 | MA | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316995200000",
"number": "1982987020",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "163 ELM ST",
"address_2": "3",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "021443110",
"telephone_number": "617-571-8058"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "163 ELM ST",
"address_2": "3",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "021443110",
"telephone_number": "617-571-8058"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VICHNIAC",
"first_name": "ALEXIS",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-26",
"last_updated": "2011-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "MA",
"license": "442207 7335",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Somerville, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.