Active NPI
Marsha Vannicelli, PH.D.
- Clinical Psychologist
- Cambridge, MA
National Provider Identifier
1992745467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 318
- Practice address
- 545 Concord Ave
Cambridge, MA 02138-1125 - Phone
- (617) 499-9992
- Fax
- (617) 876-0199
- NPI assigned
- Jun 6, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 318 | MA | Primary |
Addresses
Primary practice location
545 Concord Ave
Cambridge, MA 02138-1125
Mailing address
545 Concord Ave
Cambridge, MA 02138-1125
Phone (617) 499-9992
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| W01353 | Other | MA | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Apr 1, 2014 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 318 | MA | MD | Hearing Instrument Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1992745467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "545 CONCORD AVE",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021381125",
"telephone_number": "617-499-9992",
"fax_number": "617-876-0199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "545 CONCORD AVE",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021381125",
"telephone_number": "617-499-9992",
"fax_number": "617-876-0199"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANNICELLI",
"first_name": "MARSHA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-06",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "318",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "W01353",
"state": "MA"
}
],
"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 Jul 13, 2026; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.