Individual provider Active NPI

Brian Wayne Litzenberger, PH.D.

  • Psychologist
  • Worcester, MA
National Provider Identifier
1992709448
Registry record updated Jul 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
7573 Issued in MA
Practice address
9 Cedar St
Worcester, MA 01609-2505
Phone
(508) 767-1809
Fax
(508) 755-8645
NPI assigned
Jun 10, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 7573 MA Primary

Addresses

Primary practice location

9 Cedar St
Worcester, MA 01609-2505

Mailing address

9 Cedar St
Worcester, MA 01609-2505
Phone (508) 767-1809

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
I20120418000394 MA Practitioner - Clinical Psychologist 4385805332 Practice locations: Worcester, MA; Cambridge, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

130 Elm St
Suite 100
Worcester, MA 01609-1903
Phone (617) 999-7581

875 Massacusetts Ave
Suite 82
Cambridge, MA 02139-3071
Phone (617) 999-7581

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7573MAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Norma L. Medway, Psy.D.PC Psychologist Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278028800000",
    "number": "1992709448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 CEDAR ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016092505",
            "telephone_number": "508-767-1809",
            "fax_number": "508-755-8645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 CEDAR ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016092505",
            "telephone_number": "508-767-1809",
            "fax_number": "508-755-8645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITZENBERGER",
        "first_name": "BRIAN",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2010-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "7573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.