DR. JENICE AMY ELY


Address: 4 Militia Dr, Suite 15, Lexington, MA 02421-4737
Phone: 7816741121

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).

Provider Overview

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

Taxonomy

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

Office Location

Street Address 4 MILITIA DR
SUITE 15
City LEXINGTON
State MA
Zip Code 02421-4737

Providers in the same location

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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 103G00000X
Grouping Behavioral Health & Social Service Providers
Classification Clinical Neuropsychologist

Taxonomy Definition

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]

Providers in the same taxonomy and city

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
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Competitor

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City LEXINGTON
Zip Code 02421

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Dataset Information

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.

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