DAVID LEO PENDERGAST (NPI# 1942826813) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942826813 |
| Entity Type | Individual |
| Full Name | DAVID LEO PENDERGAST |
| Other Name | DR. DAVID L PENDERGAST |
| Credential | PH.D |
| Practice Address |
36 A St Unit 6c Boston MA 02127-1870 |
| Practice Telephone | 6169108915 |
| Mailing Telephone | 6169108915 |
| Enumeration Date | 2020-06-17 |
| Last Update Date | 2020-06-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 4581-PY-PR | MA | Behavioral Health & Social Service Providers |
| Street Address |
36 A ST UNIT 6C |
| City | BOSTON |
| State | MA |
| Zip Code | 02127-1870 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598370629 | Peaceful Healing Soul Counseling Center, LLC | Counselor | Online Therapy, Boston, MA 02127 | 2020-09-15 |
| 1568964914 | Phuong Luu | Nurse Practitioner | 606 E Fourth St, Unit 204, Boston, MA 02127 | 2018-03-01 |
| 1700304367 | Kelsey L Donovan | Physician Assistant | 431 E 3rd Street Apt 2, Boston, MA 02127 | 2017-09-05 |
| 1255873733 | Janet Villafane | Social Worker | 23 Mcdonough Way, 691, Boston, MA 02127 | 2016-11-15 |
| 1083088470 | Katie Ryan | Counselor | 8 Rev Burke Street #151, South Boston, MA 02127 | 2015-11-23 |
| 1184005514 | Keith A Lombard | Counselor | 1226a Columbia Rd., South Boston, MA 02127 | 2015-06-11 |
| 1609213917 | Nicole Ashley Vandermay | Student in an Organized Health Care Education/Training Program | 9 Woodward St, Apt. 3, Boston, MA 02127 | 2013-05-28 |
| 1922359777 | Elizabeth Raggi | Counselor | 49 L Street, South Boston, MA 02127 | 2012-09-19 |
| 1205181021 | Massachusetts General Hospital | General Acute Care Hospital | 256 West Sixth Street Apt 2, South Boston, MA 02127 | 2012-07-18 |
| 1154602126 | Madeline F Brisotti | Counselor | 8 Reverend Burke Steet, South Boston, MA 02127 | 2011-09-06 |
| Find all providers in zip 02127 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841897345 | Sade Callwood | Psychologist | 185 Devonshire St Ste 800, Boston, MA 02110-1414 | 2020-10-07 |
| 1184239808 | Morgan Eleanor Smigielski | Psychologist | 65 Park Dr Apt 18, Boston, MA 02215-5238 | 2020-09-10 |
| 1679183230 | Holly Muller | Psychologist | 225 Friend St, Boston, MA 02114-1800 | 2020-08-07 |
| 1063035566 | Hermine Muskat | Psychologist | 1313 Washington St Apt 521, Boston, MA 02118-2170 | 2020-05-19 |
| 1750914503 | Stephanie Petit Jean Louis | Psychologist | 80 Fenwood Rd Unit 405, Boston, MA 02115-6138 | 2020-02-20 |
| 1164078754 | Alexandria Miller | Psychologist | 801 Massachusetts Ave # 2067, Boston, MA 02118-2605 | 2019-08-10 |
| 1356824288 | Mira Mooreville Nurko | Psychologist | 71 Rockview St, Boston, MA 02130-2147 | 2018-09-06 |
| 1083195416 | Lawrence Pilkington Stifler | Psychologist | 99 Summer St Fl 12, Boston, MA 02110-1213 | 2018-08-23 |
| 1952896326 | Amy R. Pettit | Psychologist | 11 Deerfield St, Boston, MA 02215-5600 | 2018-06-27 |
| 1609360510 | Trustees of Tufts College | Psychologist | 1 Kneeland St Fl 6, Boston, MA 02111-1527 | 2018-06-15 |
| Find all providers in BOSTON | ||||
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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.