Active NPI
Karen Zwillenberg, PH.D.
- Clinical Psychologist
- Canton, MA
National Provider Identifier
1992114912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 10414
- Practice address
- 95 Washington St Ste 104-238
Canton, MA 02021-4006 - Phone
- (781) 908-3551
- NPI assigned
- Aug 4, 2014
- Last updated
- Jun 6, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Clinical Psychologist | 103TC0700X | 10414 | MA | Primary |
Addresses
Primary practice location
95 Washington St Ste 104-238
Canton, MA 02021-4006
Mailing address
95 Washington St Ste 104-238
Canton, MA 02021-4006
Phone (781) 908-3551
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161118001868 | MA | Practitioner - Clinical Psychologist | 6901185719 | Practice locations: Canton, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2013
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
95 Washington St
Suite 224 238
Canton, MA 02021-4006
Phone (781) 908-3551
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686009600000",
"number": "1992114912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "95 WASHINGTON ST STE 104-238",
"city": "CANTON",
"state": "MA",
"postal_code": "020214006",
"telephone_number": "781-908-3551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "95 WASHINGTON ST STE 104-238",
"city": "CANTON",
"state": "MA",
"postal_code": "020214006",
"telephone_number": "781-908-3551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZWILLENBERG",
"first_name": "KAREN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-08-04",
"last_updated": "2023-06-06",
"certification_date": "2023-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "10414",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.