DR. JACQUELYN MINAHAN (PHD) – Mental Health Counselor, NPI 1083013700

DR. JACQUELYN MINAHAN (PHD) is a healthcare provider. based in Franklin, Massachusetts. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. PSYC0005602 (CO). The NPI Number for DR. JACQUELYN MINAHAN (PHD) is 1083013700

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
DR. JACQUELYN MINAHAN (PHD)
NPI
1083013700
Phone
Not provided
Address
191 DAVID RD
Enumeration Date
19 August 2014
Last Update Date
7 October 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3033384545
Graduation Year
2020 (6 years ago)
PAC ID
9931592458
Group Practice PAC ID
1254238454
Professional Enrollment ID
I20220204002228
Address ID
CO800263370LA280XXCIRC301

Contacts

SOAP Endpoint
https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience56
Completeness85
Years active:11State licenses:1Other namesUpdated within 12 months

1,694 CLINICAL PSYCHOLOGIST in MA

Provider Addresses for DR. JACQUELYN MINAHAN (PHD)

  • 191 DAVID RD

    FRANKLIN, MA 020381617

    Phone:

    Type: Mailing

  • 10350 E DAKOTA AVE

    DENVER, CO 802471309

    Phone:

    Type: Mailing

  • 280 EXEMPLA CIR

    LAFAYETTE, CO 800263370

    Phone: (303) 338-4545

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-02-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220204002228IClinical PsychologistCOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02038)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1254238454View full group profile
NameSpecialtyState
Nurse PractitionerCO
-CO
Physical Therapist In Private PracticeCO
-CO
-CO
-CO
Cardiovascular Disease (Cardiology)CO
Physical Therapist In Private PracticeCO
Physical Therapist In Private PracticeCO
Family PracticeCO

Reviews

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Frequently asked questions

What NPI should I save for DR. JACQUELYN MINAHAN (PHD)?
Save NPI 1083013700 if you need a stable reference for DR. JACQUELYN MINAHAN (PHD).
Is DR. JACQUELYN MINAHAN (PHD)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does DR. JACQUELYN MINAHAN (PHD) list a primary specialty?
If you are matching referrals, note Mental Health Counselor for DR. JACQUELYN MINAHAN (PHD). Clinical services aligned with this taxonomy classification.
What location metadata exists for DR. JACQUELYN MINAHAN (PHD)?
The page summarizes Franklin, Massachusetts for DR. JACQUELYN MINAHAN (PHD); expand the address list for detail.
Is DR. JACQUELYN MINAHAN (PHD) a real provider?
This page reflects official NPPES data for NPI 1083013700. Always confirm identity and privileges with the practice and licensing boards.

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