PAX ET BONUM PSYCHOLOGICAL SERVICES, LLC (NPI# 1851814917) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851814917 |
| Entity Type | Organization |
| Organization Name | PAX ET BONUM PSYCHOLOGICAL SERVICES, LLC |
| Practice Address |
10 Concord Ave Cambridge MA 02138-2322 |
| Mailing Address |
93 Oxford St # 2 Arlington MA 02474-6907 |
| Practice Telephone | 6175159902 |
| Mailing Telephone | 6175159902 |
| Enumeration Date | 2017-07-20 |
| Last Update Date | 2017-07-20 |
| Authorized Official Name | DR. KRISTEN K ELLARD (PSYCHOLOGIST/SOLE MEMBER) |
| Authorized Official Telephone | 6175159902 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
10310 | MA | Ambulatory Health Care Facilities |
| Street Address |
10 CONCORD AVE |
| City | CAMBRIDGE |
| State | MA |
| Zip Code | 02138-2322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043271471 | Leslie Cutler | Social Worker | 10 Concord Ave, Cambridge, MA 02138-2322 | 2006-03-28 |
| 1245840412 | Clinton Fuller | Behavioral Analyst | 10 Concord Ave, Cambridge, MA 02138-2322 | 2020-08-03 |
| 1356974224 | Carissa Melillo LLC | Clinic/Center | 10 Concord Ave, Cambridge, MA 02138-2322 | 2020-02-19 |
| 1114409489 | Clinical Alliances Services, LLC | Psychologist | 10 Concord Ave, Cambridge, MA 02138-2322 | 2018-09-04 |
| 1578049037 | Kristen E. Bettencourt | Psychologist | 10 Concord Ave, Cambridge, MA 02138-2322 | 2018-07-17 |
| 1629564513 | Renee Jane Outland | Occupational Therapist | 10 Concord Ave, Cambridge, MA 02138 | 2018-07-03 |
| 1205329323 | Karen Melissa Stufflebeam | Psychologist | 10 Concord Ave, Cambridge, MA 02138-2322 | 2018-06-13 |
| 1457869745 | Courtney Ann Rotolo | Social Worker | 10 Concord Ave, Cambridge, MA 02138-2322 | 2018-01-20 |
| 1215455340 | Alison Mamatey | Counselor | 10 Concord Ave, Cambridge, MA 02138-2322 | 2017-09-09 |
| 1326578873 | Carissa Jude Melillo | Counselor | 10 Concord Ave, Cambridge, MA 02138-2322 | 2017-06-18 |
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| 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 | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316565005 | Mds Counseling Services, LLC | Clinic/Center | 186 Alewife Brook Pkwy # 1019, Cambridge, MA 02138-1121 | 2020-07-08 |
| 1649801242 | Ascent Arts and Counseling, LLC | Clinic/Center | 1158 Massachusetts Ave Ste 307, Cambridge, MA 02138-5205 | 2020-02-01 |
| 1972084119 | Healing Journey Counseling, LLC | Clinic/Center | 40 Russell St Unit 1, Cambridge, MA 02140-1310 | 2018-08-26 |
| 1013141993 | Nora Ilniczky, Ph.d., Psychotherapy and Wellbeing, LLC. | Clinic/Center | 1158 Massachusetts Ave, Suite #307, Cambridge, MA 02138-5205 | 2009-05-07 |
| 1275191199 | Annkatrine Gates Psy.d. Pllc | Clinic/Center | 545 Concord Ave, Cambridge, MA 02138-1125 | 2019-06-05 |
| 1205319464 | Dr. Beth A. Good Dnp, Aprn, Pmhcns-bc, LLC | Clinic/Center | 145 2nd Ave Se, Cambridge, MN 55008-1602 | 2018-09-12 |
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| 1669079729 | Inner Resources Counseling, PC | Clinic/Center | 74 Atlantic Ave, Marblehead, MA 01945-3066 | 2020-10-02 |
| 1255947701 | Women's Wellness Initiative | Clinic/Center | 127 South St Unit 2249, Plainville, MA 02762-7728 | 2020-09-21 |
| 1124633441 | Illusions of Samsara | Clinic/Center | 353 Sea St Apt 5, Quincy, MA 02169-2722 | 2020-09-14 |
| 1053925420 | Elizabeth Klish, Psyd, LLC | Clinic/Center | 9 Euclid Cir, Natick, MA 01760-1923 | 2020-09-03 |
| 1184240152 | Havins Psychological Services, LLC | Clinic/Center | 18 Kingman St, Weymouth, MA 02188-2209 | 2020-06-24 |
| 1700402906 | Elizabeth Barr Licsw LLC | Clinic/Center | 4 Crestwood Dr, Blackstone, MA 01504-1108 | 2020-06-23 |
| 1780200352 | Tammy B. Bringaze Phd Pllc | Clinic/Center | 199 Main St Ste 3, Northampton, MA 01060-3151 | 2020-06-19 |
| 1598387235 | E E Barch Psyd LLC | Clinic/Center | 10 Navarro Cir, Medford, MA 02155-2048 | 2020-05-16 |
| 1346875069 | Michael D Schreiber Np PC | Clinic/Center | 1180 Beacon St Ste 4c, Brookline, MA 02446-3806 | 2020-03-04 |
| 1629600929 | John G. Giragos Jr. Md LLC | Clinic/Center | 132 Indian Pipe Ln, Concord, MA 01742-4766 | 2020-02-05 |
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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.