DR. MARK RANDOLPH ELIN (NPI# 1366460891) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366460891 |
| Entity Type | Individual |
| Full Name | DR. MARK RANDOLPH ELIN |
| Credential | PH.D. |
| Practice Address |
1200 Converse St Suite 102 Longmeadow MA 01106-1760 |
| Practice Telephone | 4135679244 |
| Mailing Telephone | 4135679244 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 4026 | MA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 0522589 | 05 |
| Street Address |
1200 CONVERSE ST SUITE 102 |
| City | LONGMEADOW |
| State | MA |
| Zip Code | 01106-1760 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851372247 | Thomas A. Lachiusa | Social Worker | 1200 Converse St, Converse Professional Building, Longmeadow, MA 01106-1760 | 2005-11-11 |
| 1679107957 | Matthew Riley, Lmhc | Counselor | 1200 Converse St, Longmeadow, MA 01106-1675 | 2020-02-26 |
| 1104476613 | Am Medical PC | Internal Medicine | 1200 Converse St, Longmeadow, MA 01106-1675 | 2019-09-17 |
| 1891127668 | Amanda Derby | Marriage & Family Therapist | 1200 Converse St, Longmeadow, MA 01106-1675 | 2013-08-05 |
| 1407123300 | Kelly Trombly-bujnicki | Social Worker | 1200 Converse St, Suite 202, Longmeadow, MA 01106-1675 | 2011-11-20 |
| 1417184698 | Nicole C. Esposito | Counselor | 1200 Converse St, # 3l, Longmeadow, MA 01106-1675 | 2009-06-16 |
| 1437328036 | Joseph P. Critelli | Counselor | 1200 Converse St, Longmeadow, MA 01106-1760 | 2008-02-27 |
| 1619184058 | Donald Coombs Jr. | Counselor | 1200 Converse St, Longmeadow, MA 01106-1760 | 2007-05-16 |
| 1265648398 | Richard K Fleming | Social Worker | 1200 Converse St, Suite 201, Longmeadow, MA 01106-1760 | 2007-05-15 |
| 1821167776 | Kimberlee Margeson Green | Counselor | 1200 Converse St, 201, Longmeadow, MA 01106-1760 | 2006-11-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831797646 | Paula Arrigg | Counselor | 175 Dwight Road, Longmeadow, MA 01106 | 2020-10-14 |
| 1003429010 | Optimal Therapy Solutions, LLC | Clinic/Center | 127 Bel Air Drive, Longmeadow, MA 01106 | 2020-08-28 |
| 1164840666 | Erin Feller | Pediatrics | 123 Dwight Rd., Longmeadwod, MA 01106 | 2014-04-01 |
| 1255611299 | Christina Rose Lalime | Community Health Worker | 206 Bel Air Dive, Longmeadow, MA 01106 | 2011-08-22 |
| 1851503742 | Andrew M. Oxman | Counselor | 1200 Converse Street, Longmeadow, MA 01106 | 2007-05-04 |
| 1093833048 | Lilly Gaev | Social Worker | Therapeutic Associates PC, 167 Dwight Rd #104, Longmeadow, MA 01106 | 2007-03-27 |
| 1093840530 | Julie A Cox | Psychologist | 167 Dwight Rd #104, Therapeutic Associates PC, Longmeadow, MA 01106 | 2007-02-23 |
| 1932252897 | Karen Elizabeth Marsian | Podiatrist | 123 Dwight Road, Suite 13 W1, Longmeadow, MA 01106 | 2007-01-22 |
| 1386700227 | Visions of Longmeadow | Eyewear Supplier (Equipment, not the service) | 471 Longmeadow Street, Visions of Longmeadow, Longmeadow, MA 01106 | 2006-12-28 |
| 1437226701 | Richard T. Longo | Psychologist | 167 Dwight Road, Suite #104, Longmeadow, MA 01106 | 2006-11-29 |
| Find all providers in zip 01106 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104037670 | Frederick Scott Kadushin | Clinical Neuropsychologist | 136 Dwight Rd, Longmeadow, MA 01106-1759 | 2007-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154949873 | Erica Rose Appleman | Clinical Neuropsychologist | 134 Horace St, Boston, MA 02128-1581 | 2020-07-09 |
| 1578187613 | Nancy Schneider-pruett | Clinical Neuropsychologist | The Neuropsychology Service, 100 Cummings Center, Beverly, MA 01982 | 2020-06-04 |
| 1194365312 | Erin Grace Kitchener | Clinical Neuropsychologist | 1 Wells Ave Fl 4, Newton, MA 02459-3211 | 2020-01-15 |
| 1407330509 | Coastal Psychological Center, LLC. | Clinical Neuropsychologist | 36 Woburn St Ste 6, Reading, MA 01867-2903 | 2018-09-24 |
| 1881102515 | Matthew S Conway | Clinical Neuropsychologist | 26 Chestnut St Ste 2e, Andover, MA 01810-3600 | 2018-01-16 |
| 1811415326 | Francesca Lavecchia | Clinical Neuropsychologist | Brockto Area Multi Service, Inc. 10 Christy Dr., Brockton, MA 02301 | 2017-09-05 |
| 1346792637 | Margaret Alice Mcphee | Clinical Neuropsychologist | 29 Regina Dr, Chelmsford, MA 01824-4540 | 2016-11-02 |
| 1154870814 | Jessica Pan | Clinical Neuropsychologist | 1 Bowdoin St, 7th Floor, Boston, MA 02114-4201 | 2016-09-22 |
| 1508217506 | Donald Bearden | Clinical Neuropsychologist | 30 Iroquois St, Unit 33, Roxbury Crossing, MA 02120-2848 | 2016-06-30 |
| 1497115612 | Susan Magocsi | Clinical Neuropsychologist | 13 Meetinghouse Ln, Milton, MA 02186-2415 | 2016-03-01 |
| Find all providers with the same taxonomy | ||||
| City | LONGMEADOW |
| Zip Code | 01106 |
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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.