Mindful Paths Psychological Testing – Clinical Psychologist, NPI 1104390525
Clinical Psychologist
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Mindful Paths Psychological Testing
50 Main St Ste 210
North Reading, MA 018642281
Phone: (800) 593-2560
Type: Location
136 DWIGHT RD
LONGMEADOW, MA 011062075
Phone: (781) 287-8676
Fax: (800) 593-2560
Type: Mailing
32 COURT ST STE 7
PLYMOUTH, MA 023608733
Phone: (774) 426-7707
Fax: (800) 593-2560
Type: Location
50 Main St Ste 201
North Reading, MA 018642281
Phone: (774) 426-7707
Fax: (800) 593-2560
Type: Location
5, Summer Street, Kingston, Ulster County, New York, 12401, United States
KINGSTON, MA 023641275
Phone: (800) 593-2560
Fax: (800) 593-2560
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: 2019-06-05
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-09-30 (618 days ago).
Enrollment records
1
Earliest due date
2024-09-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20190605000184 | O | Clinic/Group Practice | MA | 2024-09-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 01864)
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