MR. JEFFREY EMANNUEL PROPHETE (NPI# 1568748101) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568748101 |
| Entity Type | Individual |
| Full Name | MR. JEFFREY EMANNUEL PROPHETE |
| Practice Address |
44 Diauto Dr Randolph MA 02368-4536 |
| Mailing Address |
42-44 Diauto Dr. Randolph MA 02368 |
| Practice Telephone | 7818857252 |
| Practice Fax Number | 7818857256 |
| Mailing Telephone | 7818857252 |
| Mailing Fax Number | 7818857256 |
| Enumeration Date | 2011-10-27 |
| Last Update Date | 2011-10-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
272916353 | MA | Behavioral Health & Social Service Providers |
| Street Address |
44 DIAUTO DR |
| City | RANDOLPH |
| State | MA |
| Zip Code | 02368-4536 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811210594 | Lamour By Design, Inc | Community/Behavioral Health | 44 Diauto Dr, Randolph, MA 02368-4536 | 2010-03-09 |
| 1740880996 | Robert A Grigore | Behavioral Analyst | 44 Diauto Dr, Randolph, MA 02368-4536 | 2020-10-27 |
| 1144827882 | Thalia Roman | Assistant Behavior Analyst | 44 Diauto Dr, Randolph, MA 02368-4536 | 2020-10-06 |
| 1073110128 | Chie Mitsui | Counselor | 44 Diauto Dr, Randolph, MA 02368-4536 | 2020-10-01 |
| 1104432392 | Jolie Vilmeli Medrano | Assistant Behavior Analyst | 44 Diauto Dr, Randolph, MA 02368-4536 | 2020-09-22 |
| 1518577071 | Anna Rebecca Rose Kancharla | Social Worker | 44 Diauto Dr, Randolph, MA 02368-4536 | 2020-08-08 |
| 1023636123 | Emily Tieu | Case Manager/Care Coordinator | 44 Diauto Dr, Randolph, MA 02368-4536 | 2020-07-06 |
| 1538780309 | Jerilynn Mejia | Case Manager/Care Coordinator | 44 Diauto Dr, Randolph, MA 02368-4536 | 2020-05-02 |
| 1619500329 | Regine Beris | Behavior Technician | 44 Diauto Dr, Randolph, MA 02368-4536 | 2020-02-20 |
| 1871124602 | Hasna Kazi | Case Manager/Care Coordinator | 44 Diauto Dr, Randolph, MA 02368-4536 | 2020-01-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962016444 | Kadiatou Djindji Bah | Behavior Technician | 75 N Main St Suite 628, Randolph, MA 02368 | 2020-09-02 |
| 1194334490 | Madison Murphy | Behavior Technician | 75 North Main Street, Ma, Suite #628, Randolph, MA 02368 | 2020-07-23 |
| 1255995049 | Daniel Joseph Bellistri | Social Worker | Daniel Bellistri, 70 Memorial Pkwy., Randolph, MA 02368 | 2019-04-26 |
| 1992291124 | Ashley Lauren Davis | Licensed Practical Nurse | 11 Mcdonnell Drive, Randolph, MA 02368 | 2018-07-11 |
| 1023503943 | Jean Rony Mesalon | Licensed Practical Nurse | 8 Reynolds Ave, Randolph, MA 02368 | 2018-06-22 |
| 1154829208 | Tatianna Lovette Hendren | Behavioral Analyst | 28 Liberty Place, Apartment C, Randolph, MA 02368 | 2018-01-24 |
| 1841709698 | Gerica Barbosa | Counselor | 37 Sarah St, Randolph, MA 02368 | 2017-09-25 |
| 1437508629 | Julie A Panchamsingh-barakat | Social Worker | 400-, 402 N Main St, Randolph, MA 02368 | 2016-06-08 |
| 1497109789 | Grace Dorcas Pokuah | Counselor | 24 Nelson Dr, #1a, Randolph, MA 02368 | 2016-04-22 |
| 1194185868 | Heavenly Home Care | Home Health | 9 William Morrison Drive, Randolph, MA 02368 | 2016-02-24 |
| Find all providers in zip 02368 | ||||
| Taxonomy Code | 103TB0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Cognitive & Behavioral |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952838955 | The May Institute, Inc | Psychologist | 14 Pacella Park Dr, Randolph, MA 02368-1756 | 2017-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740807528 | Centi Psychological Services Pllc | Psychologist | 35 Renwick Rd, Melrose, MA 02176-1218 | 2020-06-29 |
| 1760008072 | Louise Ross | Psychologist | 223 Bishops Forest Dr, Waltham, MA 02452-8804 | 2020-06-23 |
| 1417419060 | John Benjamin Barnes | Psychologist | 76 Davidson Rd, Framingham, MA 01701-3292 | 2019-04-03 |
| 1508351107 | Breanna Wardwell | Psychologist | 110 Maple St Ste 110, Springfield, MA 01105 | 2018-06-26 |
| 1376038372 | Ellen Leigh | Psychologist | 8 Summer St Apt 105, Arlington, MA 02474-3059 | 2018-06-22 |
| 1538650601 | Leonard Anthony Doerfler | Psychologist | 26 Pinedale Rd, Shrewsbury, MA 01545-3502 | 2018-05-24 |
| 1700389749 | Arden Sugeily Lake | Psychologist | 50 Annafran St, Roslindale, MA 02131-4705 | 2018-03-15 |
| 1780183277 | Laurence James Stybel | Psychologist | 27 Bayfield Rd, Wayland, MA 01778-4205 | 2018-02-09 |
| 1114449931 | Stephanie M Ribeiro | Psychologist | 27 Stratfield Ave, Westfield, MA 01085-2222 | 2017-07-13 |
| 1033650908 | Jean Curtis Loud | Psychologist | 17 East Chop Drive, Oak Bluffs, MA 02557 | 2017-03-13 |
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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.