Individual provider Active NPI

Candyce Burke Auguste, PSY.D.

  • Health Service Psychologist
  • Boston, MA
National Provider Identifier
1992092670
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service PsychologistTaxonomy code 103TH0100X
License
11098 Issued in MA
Practice address
6 Liberty Square
PMB #348
Boston, MA 02109-5800
Phone
(857) 288-8841
NPI assigned
Jul 1, 2011
Last updated
Oct 13, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Health Service Psychologist 103TH0100X 11098 MA Primary

Addresses

Primary practice location

6 Liberty Square
PMB #348
Boston, MA 02109-5800

Mailing address

6 Liberty Square
PMB #348
Boston, MA 02109-5800
Phone (857) 288-8841

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
I20231019001166 MA Practitioner - Clinical Psychologist 5991151409 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Crosspoint Clinical Services IncGroup PAC ID 8921392317, 13 clinicians

Practice addresses (Care Compare)

117 Park Ave
Suite 201a
West Springfield, MA 01089-3371
Phone (413) 732-7677

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11098MAMDClinical Social Worker

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1992092670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 LIBERTY SQUARE",
            "address_2": "PMB #348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021095800",
            "telephone_number": "857-288-8841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 LIBERTY SQUARE",
            "address_2": "PMB #348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021095800",
            "telephone_number": "857-288-8841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUGUSTE",
        "first_name": "CANDYCE",
        "middle_name": "BURKE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-01",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "MA",
            "license": "11098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.