DR. GRANT LOREN IVERSON (NPI# 1033524913) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033524913 |
| Entity Type | Individual |
| Full Name | DR. GRANT LOREN IVERSON |
| Credential | PHD |
| Practice Address |
Home Base Program 101 Merrimac Street, 2nd Floor Boston MA 02114 |
| Practice Telephone | 6175732770 |
| Mailing Telephone | 6175732770 |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2014-07-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 9828 | MA | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
9828 | MA | Behavioral Health & Social Service Providers |
| Street Address |
HOME BASE PROGRAM 101 MERRIMAC STREET, 2ND FLOOR |
| City | BOSTON |
| State | MA |
| Zip Code | 02114 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487102349 | Rene Marie Lento | Psychologist | Home Base Program, 101 Merrimac Street, 2nd Floor, Boston, MA 02114 | 2016-09-20 |
| 1740663996 | Noah D Silverberg | Student in an Organized Health Care Education/Training Program | Home Base Program, 101 Merrimac Street, 2nd Floor, Boston, MA 02114 | 2015-07-07 |
| 1750786653 | Magdalena Wojtowicz | Psychologist | Home Base Program, 101 Merrimac Street, 2nd Floor, Boston, MA 02114 | 2014-11-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588276281 | Guoliang Qiao | Student in an Organized Health Care Education/Training Program | Massachusetts General Hospital, 55 Fruit Street., Boston, MA 02114 | 2020-08-24 |
| 1881223741 | Alexander Wesley Zirulnik | Student in an Organized Health Care Education/Training Program | 55 Fruit St. Boston, Boston, MA 02114 | 2020-04-03 |
| 1376170548 | Mia Yu Bothwell | Student in an Organized Health Care Education/Training Program | Gray Bigelow 730, 55 Fruit Street, Boston, MA 02114 | 2020-03-26 |
| 1225661036 | David Dongkyung Kim | Student in an Organized Health Care Education/Training Program | 6 Whittier Place, Apartment 15b, Boston, MA 02114 | 2020-02-20 |
| 1124651658 | Madeleine Sertic | Student in an Organized Health Care Education/Training Program | Division of Abdominal Imaging, Department of Radiology, 55 Fruit Street, White 270, Boston, MA 02114 | 2020-02-12 |
| 1285274498 | Jiuk James Jung | Student in an Organized Health Care Education/Training Program | 15 Parkman Ave, Wang 4-460, Boston, MA 02114 | 2020-01-15 |
| 1831740448 | Jennifer Hughes | Physician Assistant | 55 Fruit Street, Founders 110, Boston, MA 02114 | 2019-09-25 |
| 1558827220 | Aluma Chovel Sella | Student in an Organized Health Care Education/Training Program | Massgeneral Hospital for Children Main Campus, 55 Fruit Street, Boston, MA 02114 | 2019-02-18 |
| 1083187140 | Henry Oliveras | Massage Therapist | 102 Charles Street, Boston, MA 02114 | 2019-01-10 |
| 1720550031 | Nicole M Price | Social Worker | 29 Staniford St, Boston, MA 02114 | 2018-12-27 |
| Find all providers in zip 02114 | ||||
| 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 |
|---|---|---|---|---|
| 1154949873 | Erica Rose Appleman | Clinical Neuropsychologist | 134 Horace St, Boston, MA 02128-1581 | 2020-07-09 |
| 1154870814 | Jessica Pan | Clinical Neuropsychologist | 1 Bowdoin St, 7th Floor, Boston, MA 02114-4201 | 2016-09-22 |
| 1396175410 | Daniel R. Seichepine | Clinical Neuropsychologist | 725 Albany St # 7b, Boston Medical Center, Boston, MA 02118-2526 | 2013-11-27 |
| 1235566647 | Todd M Solomon | Clinical Neuropsychologist | 72 East Concord Street, B-7800, Boston University School of Medicine, Boston, MA 02118 | 2013-09-30 |
| 1598015984 | Neuropath LLC | Clinical Neuropsychologist | 106 Queensberry St, # 18, Boston, MA 02215-4713 | 2012-09-13 |
| 1619236718 | Justin Centi | Clinical Neuropsychologist | 185 Devonshire St Ste 901b, Boston, MA 02110-1407 | 2012-05-09 |
| 1740513886 | Aparna Rao | Clinical Neuropsychologist | 75 Arlington St, Suite 500, Boston, MA 02116-3936 | 2009-09-08 |
| 1386845998 | Andrea L Piatt | Clinical Neuropsychologist | 321 Columbus Ave Ste 3, Boston, MA 02116-5168 | 2007-05-30 |
| 1417158288 | Robyn Kervick | Clinical Neuropsychologist | 160 Commonwealth Avenue, Suite U3, Boston, MA 02116 | 2007-05-30 |
| 1609907252 | Ginette Lafleche | Clinical Neuropsychologist | 27 Brahms St, Boston, MA 02131-4011 | 2007-03-07 |
| 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.