IDALIANA MEDINA (NPI# 1467068866) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467068866 |
| Entity Type | Individual |
| Full Name | IDALIANA MEDINA |
| Credential | M.ED. |
| Practice Address |
11 Sycamore St Worcester MA 01608-2213 |
| Mailing Address |
Po Box 73 Worcester MA 01613-0073 |
| Practice Telephone | 5087981900 |
| Enumeration Date | 2020-09-21 |
| Last Update Date | 2020-09-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
Behavioral Health & Social Service Providers |
| Street Address |
11 SYCAMORE ST |
| City | WORCESTER |
| State | MA |
| Zip Code | 01608-2213 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154653814 | Isaac Hernandez | Social Worker | 11 Sycamore St, Worcester, MA 01608-2213 | 2010-02-05 |
| 1598300568 | Lisa Premo | Counselor | 11 Sycamore St, Worcester, MA 01608-2213 | 2019-11-13 |
| 1811532898 | Eduardo Cintron Torres | Counselor | 11 Sycamore St, Worcester, MA 01608-2213 | 2019-11-13 |
| 1306408927 | Donovan Snyder | Counselor | 11 Sycamore St, Worcester, MA 01608-2213 | 2019-07-03 |
| 1437711389 | Paola Gutierrez | Counselor | 11 Sycamore St, Worcester, MA 01608-2213 | 2019-07-01 |
| 1962069542 | Felicia Appiah-kubi | Counselor | 11 Sycamore St, Worcester, MA 01608-2213 | 2019-05-20 |
| 1992369573 | Josue J Rosario | Counselor | 11 Sycamore St, Worcester, MA 01608-2213 | 2019-04-29 |
| 1720569890 | Jessica Mirabal | Counselor | 11 Sycamore St, Worcester, MA 01608-2213 | 2018-08-27 |
| 1851879498 | Rachel Katherine Dilima | Counselor | 11 Sycamore St, Worcester, MA 01608-2213 | 2018-08-06 |
| 1528576246 | Caitlin Maynard | Counselor | 11 Sycamore St, Worcester, MA 01608-2213 | 2018-01-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033721733 | Rebecca Smith Morgan | Physical Therapist | Easter Seals Massachusetts, 484 Main St, Worcester, MA 01608 | 2020-08-24 |
| 1083244057 | Marc Labb | Counselor | 25 Union St 3rd Floor, Worcester, MA 01608 | 2020-01-18 |
| 1154974145 | Shanil Shah | Student in an Organized Health Care Education/Training Program | St Vincent Hospital, Department of Internal Medicine, 123 Summer Street, Worcester, MA 01608 | 2019-07-19 |
| 1194377069 | Varun Kommalapati | Student in an Organized Health Care Education/Training Program | St Vincent Hospital, 123 Summer Street, Worcester, MA 01608 | 2019-07-11 |
| 1992361182 | Jenna Recko | Physical Therapy Assistant | Easter Seals of Massachusetts, 484 Main St, Worcester, MA 01608 | 2019-05-14 |
| 1619452646 | Kara Thompson | Registered Nurse | 100 Martin Luther King Jr Blvd, Worcester, MA 01608 | 2018-09-25 |
| 1427555325 | Baran Umut Vardar | Student in an Organized Health Care Education/Training Program | 123 Summer Street, Saint Vincent Hospital Radiology Dep, Worcester, MA 01608 | 2018-04-09 |
| 1609380765 | Mary Elizabeth O'donnell | Occupational Therapist | Easter Seals Ma, 484 Main Street, Worcester, MA 01608 | 2017-11-28 |
| 1093227316 | Oasis Home Care, LLC | Home Health | 340 Main St Ste 803, Worcester, MA 01608 | 2017-10-26 |
| 1912437500 | Peter A Rondon | Social Worker | 11 Sycamore Street, Worcester, MA 01608 | 2017-06-15 |
| Find all providers in zip 01608 | ||||
| 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 |
|---|---|---|---|---|
| 1730667114 | Catherine Luckhardt | Psychologist | 335 Chandler St, Worcester, MA 01602-3441 | 2018-07-30 |
| 1962739078 | Marianne Heslington Tichovolsky | Psychologist | 275 Belmont St, Worcester, MA 01604-1675 | 2009-11-10 |
| 1295903888 | Caroline Cole | Psychologist | 21 Cedar St, Worcester, MA 01609-2530 | 2008-02-15 |
| 1477699171 | Beth M Ashenburg | Psychologist | 30 Sever St, Worcester, MA 01609-2194 | 2007-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518575786 | Eavan Miles-mason, Phd, LLC | Psychologist | 319 Peakham Rd, Sudbury, MA 01776-2757 | 2020-07-14 |
| 1184247132 | Lauren R Blakely | Psychologist | 96 Fairbanks Ave, Wellesley, MA 02481-5256 | 2020-05-26 |
| 1881220986 | Katharine Dunson Oconnell | Psychologist | 144 Forest St, Wellesley Hills, MA 02481-6832 | 2020-03-20 |
| 1710457577 | Karla Lizbet Rivas | Psychologist | 44 Mansfield St, Allston, MA 02134 | 2018-12-04 |
| 1497230684 | Marisa Katherine Glynn | Psychologist | 35 Edgar Avenue, Somerville, MA 02145 | 2018-10-03 |
| 1043706419 | Jessica Shepley | Psychologist | 72 Fox Hill Rd, Bernardston, MA 01337-9586 | 2018-07-09 |
| 1548755176 | Elizabeth F Clark | Psychologist | 16 Gleasondale Rd, Stow, MA 01775-1465 | 2018-06-26 |
| 1528552619 | Heather Duckworth Smith | Psychologist | 5 Seal Cove Ln, Hingham, MA 02043-1050 | 2018-06-21 |
| 1467946251 | Olivia Moorehead-slaughter | Psychologist | 171 Goddard Ave, Brookline, MA 02445-7412 | 2018-06-15 |
| 1710479522 | David Arnold | Psychologist | 35 Hop Brook Rd, Amherst, MA 01002-2771 | 2018-06-06 |
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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.