DR. MELISSA SUZANNEMARIA WATTENBERG (NPI# 1780771758) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780771758 |
| Entity Type | Individual |
| Full Name | DR. MELISSA SUZANNEMARIA WATTENBERG |
| Other Name | DR. MELISSA SUZANNEMARIA WATTENBERG-ULARICH |
| Credential | PH.D. |
| Practice Address |
251 Causeway St Va Boston Healthcare System Outpatient Clinic Boston MA 02114-2148 |
| Practice Telephone | 6172481089 |
| Practice Fax Number | 6172481287 |
| Mailing Telephone | 6172481089 |
| Mailing Fax Number | 6172481287 |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2007-07-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
6346 | MA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | TUFTS PROVIDER NUMBER | 006346 | 01 |
| MA | BCBS PROVIDER # | W05873 | 01 |
| MA | 1892894 | 05 | |
| MA | MA LICENSE # | 6346 | 01 |
| Street Address |
251 CAUSEWAY ST VA BOSTON HEALTHCARE SYSTEM OUTPATIENT CLINIC |
| City | BOSTON |
| State | MA |
| Zip Code | 02114-2148 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215995410 | Boston Vamc | Department of Veterans Affairs (VA) Pharmacy | 251 Causeway St, Boston, MA 02114-2148 | 2006-05-04 |
| 1720691819 | Sasha Marianna Dias | Social Worker | 251 Causeway St, Boston, MA 02114-2148 | 2020-08-28 |
| 1649830894 | Olivia Finnegan | Social Worker | 251 Causeway St, Boston, MA 02114-2148 | 2019-06-19 |
| 1982110409 | Jessica Mcleod | Social Worker | 251 Causeway St, Boston, MA 02114-2148 | 2017-12-20 |
| 1205214012 | Vanessa Lyn Weekley | Social Worker | 251 Causeway St, Boston, MA 02114-2148 | 2015-05-12 |
| 1730584624 | Eric Lefevre | Social Worker | 251 Causeway St, Boston, MA 02114-2148 | 2014-11-04 |
| 1609157411 | Meghan Shanahan | Registered Nurse | 251 Causeway St, 3rd Floor, Boston, MA 02114-2148 | 2011-09-07 |
| 1508146358 | Patricia Jeanne Lieber | Social Worker | 251 Causeway St, Boston, MA 02114-2148 | 2011-08-25 |
| 1982918850 | Nicole Bosse | Pharmacist | 251 Causeway St, Boston, MA 02114-2148 | 2010-08-03 |
| 1528224409 | Denise Marie Flynn | Social Worker | 251 Causeway St, Boston, MA 02114-2148 | 2008-07-31 |
| Find all providers in the same location | ||||
| 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 | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
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| 1992314330 | Deborah Cohen | Psychologist | 25 State St Fl 26, Boston, MA 02109-2700 | 2020-07-30 |
| 1710596697 | Boston Center for Health Psychology and Biofeedback, LLC | Psychologist | 10 Post Office Sq., Ste 800 South, Boston, MA 02109 | 2020-07-27 |
| 1619599594 | Bozena Forbes | Psychologist | 7 Clarkson St, Boston, MA 02125-2525 | 2020-05-13 |
| 1376189845 | Nicholas Alexander Livingston | Psychologist | 150 S Huntington Ave Rm B13-79, Boston, MA 02130-4817 | 2019-11-20 |
| 1306495924 | Anthony Rosellini | Psychologist | 900 Commonwealth Avenue (east), 2nd Floor, Boston, MA 02215 | 2019-09-06 |
| 1841844693 | Darcy Elizabeth Burgers | Psychologist | 450 Brookline Ave # Jf-736d, Boston, MA 02215-5450 | 2019-07-30 |
| 1780161091 | Andrea Knestel | Psychologist | 224 Clarendon St Ste 51, Boston, MA 02116-3793 | 2018-07-20 |
| 1386121630 | Miryam Yusufov | Psychologist | 375 Longwood Ave # Lw-603, Boston, MA 02215-5395 | 2018-07-19 |
| 1144715798 | Benjamin David Goodlett | Psychologist | 300 Longwood Ave Fegan 4 Genetics, Boston, MA 02115 | 2018-06-26 |
| 1033600887 | Lizabeth Roemer | Psychologist | 100 Morrissey Blvd Dept Of, Boston, MA 02125-3300 | 2018-05-28 |
| 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.