DR KERRIE LLC (NPI# 1033672100) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033672100 |
| Entity Type | Organization |
| Organization Name | DR KERRIE LLC |
| Practice Address |
10 Hawthorne Park Cambridge MA 02138-2104 |
| Mailing Address |
405 Concord Ave Unit 386 Belmont MA 02478-7818 |
| Practice Telephone | 6173725653 |
| Mailing Telephone | 6173725653 |
| Enumeration Date | 2019-04-07 |
| Last Update Date | 2019-06-11 |
| Authorized Official Name | DR. KERRIE JONGENEELEN (CLINICAL PSYCHOLOGIST) |
| Authorized Official Telephone | 6173725653 |
| Authorized Official Credential | PSY.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 103TC1900X |
Psychologist Specialization: Counseling |
Behavioral Health & Social Service Providers | ||
| N | 103TF0000X |
Psychologist Specialization: Family |
Behavioral Health & Social Service Providers | ||
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 110138961 | 05 |
| Street Address |
10 HAWTHORNE PARK |
| City | CAMBRIDGE |
| State | MA |
| Zip Code | 02138-2104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922618610 | Khushboo Vijay Bhatia | Student in an Organized Health Care Education/Training Program | Internal Medicine Residency Program, Mount Auburn Hospi, 330 Mt. Auburn Street, Cambridge, MA 02138 | 2020-08-06 |
| 1780204156 | Ashna Grover | Student in an Organized Health Care Education/Training Program | 330 Mt Auburn Street Mount Auburn Hospital, Internal Medicine Residency Program, Cambridge, MA 02138 | 2020-04-25 |
| 1790330298 | Cambridge Periodontics LLC | Dentist | 1692 Massachusetts Ave Ste 3, Cambridge, MA 02138 | 2019-08-02 |
| 1295389765 | Yulia Levit | Technician/Technologist | 1208 Massachussets Av, Cambridge, MA 02138 | 2019-08-01 |
| 1720645393 | Chinmay Tusharkumar Jani | Student in an Organized Health Care Education/Training Program | Mount Auburn Hospital, 330 Mt Auburn Street, Cambridge, MA 02138 | 2019-05-20 |
| 1386209831 | Alexander Ryan Walker | Internal Medicine | 300 Mount Auburn Street Mount Auburn Hospital, Dept. of Medicine, Cambridge, MA 02138 | 2019-05-09 |
| 1659844868 | Aimee Hsieh | Social Worker | 525 Mount Auburn Street, Cambridge, MA 02138 | 2019-01-10 |
| 1043733389 | Armida Fruzzetti | Psychologist | 900 Concord Avenue, Cambridge, MA 02138 | 2017-07-19 |
| 1174984827 | Jenna Mezin Schmid | Psychologist | 75 Mt Auburn St 4 East, Harvard University Health Services, Cambridge, MA 02138 | 2016-03-09 |
| 1316313208 | Kelly Abbott | Optometrist | 12 Eliot St., Cambridge, MA 02138 | 2015-08-14 |
| Find all providers in zip 02138 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093227928 | Spencer C. Evans | Psychologist | 1493 Cambridge St, Cambridge, MA 02139-1047 | 2017-11-01 |
| 1497011365 | Evelyn Gould | Psychologist | 10 Concord Ave, Cambridge, MA 02138-2322 | 2012-04-05 |
| 1174818843 | Erica Lee | Psychologist | 1493 Cambridge St, Cambridge Health Alliance, Cambridge, MA 02139-1047 | 2011-06-10 |
| 1184953077 | Elizabeth Driscoll | Psychologist | 1280 Massachusetts Ave, Suite 303, Cambridge, MA 02138-3840 | 2009-12-24 |
| 1841441920 | Jacqueline Sperling | Psychologist | 799 Concord Ave, Cambridge, MA 02138-1048 | 2008-10-07 |
| 1710136098 | Robyn L. Glover | Psychologist | 575 Mount Auburn St, Suite 101, Cambridge, MA 02138-4656 | 2008-09-11 |
| 1356552541 | Christopher Edward Morton | Psychologist | 799 Concord Ave, #4, Cambridge, MA 02138-1048 | 2007-05-27 |
| 1114062239 | Paul John Callahan | Psychologist | 2557 Massachusetts Ave, Cambridge, MA 02140-1020 | 2007-02-20 |
| 1477610038 | Treniece Harris | Psychologist | 1493 Cambridge St, Cambridge, MA 02139-1047 | 2007-01-03 |
| 1609932912 | David Anthony Whelan | Psychologist | 227 Concord Ave, Unit D, Cambridge, MA 02138-1334 | 2006-12-29 |
| Find all providers in CAMBRIDGE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.