DR. CAROL PEACOCK (NPI# 1720139165) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720139165 |
| Entity Type | Individual |
| Full Name | DR. CAROL PEACOCK |
| Credential | PH.D. |
| Practice Address |
158 Mount Auburn St Ste 2 Cambridge MA 02138-4876 |
| Mailing Address |
32 Fern St Auburndale MA 02466-2207 |
| Practice Telephone | 6175476200 |
| Practice Fax Number | 6175273288 |
| Mailing Telephone | 6175476200 |
| Mailing Fax Number | 6175474884 |
| Enumeration Date | 2007-01-14 |
| Last Update Date | 2016-06-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
3952 | MA | Behavioral Health & Social Service Providers |
| Street Address |
158 MOUNT AUBURN ST STE 2 |
| City | CAMBRIDGE |
| State | MA |
| Zip Code | 02138-4876 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417048877 | Ellen Kane | Social Worker | 158 Mount Auburn St, Cambridge, MA 02138-4876 | 2006-09-28 |
| 1972729135 | Caroline Robinson Baltzer | Psychologist | 158 Mount Auburn St, Cambridge, MA 02138-4876 | 2007-04-17 |
| 1265592257 | Connie Vanrheenen | Social Worker | 158 Mount Auburn St, Cambridge, MA 02138-4876 | 2006-12-11 |
| 1700967494 | Grace M. Williams | Social Worker | 158 Mount Auburn St, Cambridge, MA 02138-4876 | 2006-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922618610 | Khushboo Vijay Bhatia | Student in an Organized Health Care Education/Training Program | Internal Medicine Residency Program, Mount Auburn Hospi, 330 Mt. Auburn Street, Cambridge, MA 02138 | 2020-08-06 |
| 1780204156 | Ashna Grover | Student in an Organized Health Care Education/Training Program | 330 Mt Auburn Street Mount Auburn Hospital, Internal Medicine Residency Program, Cambridge, MA 02138 | 2020-04-25 |
| 1790330298 | Cambridge Periodontics LLC | Dentist | 1692 Massachusetts Ave Ste 3, Cambridge, MA 02138 | 2019-08-02 |
| 1295389765 | Yulia Levit | Technician/Technologist | 1208 Massachussets Av, Cambridge, MA 02138 | 2019-08-01 |
| 1720645393 | Chinmay Tusharkumar Jani | Student in an Organized Health Care Education/Training Program | Mount Auburn Hospital, 330 Mt Auburn Street, Cambridge, MA 02138 | 2019-05-20 |
| 1386209831 | Alexander Ryan Walker | Internal Medicine | 300 Mount Auburn Street Mount Auburn Hospital, Dept. of Medicine, Cambridge, MA 02138 | 2019-05-09 |
| 1659844868 | Aimee Hsieh | Social Worker | 525 Mount Auburn Street, Cambridge, MA 02138 | 2019-01-10 |
| 1043733389 | Armida Fruzzetti | Psychologist | 900 Concord Avenue, Cambridge, MA 02138 | 2017-07-19 |
| 1174984827 | Jenna Mezin Schmid | Psychologist | 75 Mt Auburn St 4 East, Harvard University Health Services, Cambridge, MA 02138 | 2016-03-09 |
| 1316313208 | Kelly Abbott | Optometrist | 12 Eliot St., Cambridge, MA 02138 | 2015-08-14 |
| Find all providers in zip 02138 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114537131 | Annemarie Baldauf, Psyd, Pllc | Psychologist | 49 Hancock St Ste 104, Cambridge, MA 02139-3188 | 2020-08-04 |
| 1881216588 | Massomeh Namavar | Psychologist | 221 Mount Auburn St Apt 104, Cambridge, MA 02138-4848 | 2020-05-15 |
| 1396367736 | Laura Genelle Meza Valencia | Psychologist | One Mifflin Place, Suite 400, Cambridge, MA 02138-4946 | 2020-05-07 |
| 1033672100 | Dr Kerrie LLC | Psychologist | 10 Hawthorne Park, Cambridge, MA 02138-2104 | 2019-04-07 |
| 1912481227 | Mary E. Ford | Psychologist | 195 Harvey St, Cambridge, MA 02140-1765 | 2018-09-21 |
| 1871089227 | Ellsworth Fersch | Psychologist | 70 Richdale Ave Apt 2, Cambridge, MA 02140-2640 | 2018-07-09 |
| 1134610751 | Jill Hooley | Psychologist | 33 Kirkland St, Cambridge, MA 02138-2044 | 2018-05-21 |
| 1053836080 | Kim Michael Woynowskie Jr. | Psychologist | 625 Mount Auburn St Ste 102, Cambridge, MA 02138-4555 | 2017-08-10 |
| 1306383351 | Elise I Welton | Psychologist | 22 Water St, Apt. 411, Cambridge, MA 02141-1257 | 2017-01-30 |
| 1174984827 | Jenna Mezin Schmid | Psychologist | 75 Mt Auburn St 4 East, Harvard University Health Services, Cambridge, MA 02138 | 2016-03-09 |
| Find all providers in CAMBRIDGE | ||||
Please comment or provide details below to improve the information on DR. CAROL PEACOCK.
| 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.