DR. JENICE AMY ELY (NPI# 1467409839) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1467409839 |
Entity Type | Individual |
Full Name | DR. JENICE AMY ELY |
Credential | PH.D. |
Practice Address |
4 Militia Dr Suite 15 Lexington MA 02421-4737 |
Mailing Address |
23 Fair Oaks Ter Lexington MA 02421-6905 |
Practice Telephone | 7816741121 |
Practice Fax Number | 7816741121 |
Mailing Telephone | 7818639518 |
Mailing Fax Number | 7816741121 |
Enumeration Date | 2006-05-30 |
Last Update Date | 2007-07-08 |
Gender Code | F |
Is Sole Proprietor | X |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
X | 103G00000X | Clinical Neuropsychologist | 6930 | MA | Behavioral Health & Social Service Providers |
X | 103TC0700X |
Psychologist Specialization: Clinical |
6930 | MA | Behavioral Health & Social Service Providers |
Street Address |
4 MILITIA DR SUITE 15 |
City | LEXINGTON |
State | MA |
Zip Code | 02421-4737 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346200193 | Susan M Brefach | Psychologist | 4 Militia Dr, Suite 23, Lexington, MA 02421-4737 | 2006-03-24 |
1760042675 | Maria Lee Busa | Occupational Therapist | 4 Militia Dr, Lexington, MA 02421-4737 | 2019-06-13 |
1730649708 | Lysa L. Pirone | Counselor | 4 Militia Dr, #23, Lexington, MA 02421 | 2019-03-25 |
1285093633 | Bria Mcnulty | Speech-Language Pathologist | 4 Militia Dr, Lexington, MA 02421-4737 | 2016-02-14 |
1316336720 | Nancy A Santoro Psyd LLC | Psychologist | 4 Militia Dr, Suite 23, Lexington, MA 02421-4737 | 2015-01-22 |
1255720900 | Healing Smile Pediatric Physical Therapy, LLC | Clinic/Center | 4 Militia Dr, Lexington, MA 02421-4737 | 2015-01-19 |
1629474366 | Growing Minds, LLC | Psychologist | 4 Militia Dr, Suite 17, Lexington, MA 02421-4737 | 2014-11-07 |
1427453067 | Meredith M Cohen | Psychologist | 4 Militia Dr, Lexington, MA 02421-4737 | 2014-10-24 |
1255734083 | Mary Poblete | Physical Therapist | 4 Militia Dr, Suite 17, Lexington, MA 02421-4737 | 2014-10-07 |
1841594272 | Victoria Begley | Speech-Language Pathologist | 4 Militia Dr, Lexington, MA 02421-4737 | 2010-12-28 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972149300 | Streettherapy,llc | Counselor | Triad Adolescent Services, 363 Mass. Ave., Suite204, Lexington, MA 02421 | 2019-11-20 |
1598249922 | Kelly Sexton | Social Worker | Labbb Collaborative Lexington High School, 251 Waltham St, MA 02421 | 2018-09-21 |
1538641956 | Jill Or Planeta | Social Worker | 40 Taft Ave, Lexington, MA 02421 | 2018-09-01 |
1902390388 | Erika Yaneth Valek | Counselor | 125 Hartwell Avenue, Lexington, MA 02421 | 2018-06-19 |
1366743668 | Elizabeth Ann Murphy | Social Worker | 17 Stedman Rd, Lexington, MA 02421 | 2010-11-03 |
1003045063 | Nils Becker | Pathology | 1 Cranberry Hill Ste 303, Lexington, MA 02421 | 2009-07-10 |
1780829556 | Lynn Joan Meltzer | Psychologist | Institute for Learning and Development, 4 Militia Drive, Lexington, MA 02421 | 2008-12-09 |
1962666511 | Kristin Stanley Rullo | Optometrist | 21 Worthen Road, Lexington, MA 02421 | 2008-07-14 |
1861660201 | Jillian S Imagire | Radiology | Concert Pharmaceuticals, 99 Hayden Ave, Suite 100, Lexington, MA 02421 | 2008-02-20 |
1144498049 | Lexington Dental Associates | Dentist | 271 Lincoln Street, Suite 2, Lexington, MA 02421 | 2008-02-13 |
Find all providers in zip 02421 |
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 |
---|---|---|---|---|
1558686725 | Daniel Kendig Reinstein Iv | Clinical Neuropsychologist | 187 Spring St, Lexington, MA 02421-8030 | 2010-03-31 |
1275735557 | Harvey Irwin Botman | Clinical Neuropsychologist | Suite 3, 15 Depot Square, Lexington, MA 02420-6330 | 2007-05-31 |
1043360936 | Hugh Coffman | Clinical Neuropsychologist | 76 Bedford St Ste 17, Lexington, MA 02420-4640 | 2007-01-11 |
1346399318 | Peter Judson Gager | Clinical Neuropsychologist | 3175 Custer Dr Ste 302b, Lexington, KY 40517-4023 | 2007-01-09 |
1861565210 | Lacey K Price | Clinical Neuropsychologist | 711 Millpond Rd, Lexington, KY 40514-1561 | 2006-11-15 |
1144306515 | David T Berry | Clinical Neuropsychologist | Psychology 125 Kastle Hall, University of Kentucky, Lexington, KY 40506-0001 | 2006-10-28 |
1851317291 | Janine Korahais Stasior | Clinical Neuropsychologist | 76 Bedford St Ste 12, Lexington, MA 02420-4640 | 2006-07-15 |
1477535250 | Timothy J Carbary | Clinical Neuropsychologist | 261 Regency Cir, Suite 4, Lexington, KY 40503-2348 | 2005-11-16 |
1285168260 | Lisa Koehl | Clinical Neuropsychologist | 740 S Limestone, Ky Clinic, J401, Lexington, KY 40536-0001 | 2017-04-17 |
1407397128 | Jordan Patrick Harp | Clinical Neuropsychologist | 740 S Limestone Ste B101, Lexington, KY 40536-0284 | 2017-03-14 |
Find all providers in LEXINGTON |
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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.