DR. DIANA HEARST IKEDA PH.D. NPI 1124146717

NPI Information

NPI: 1124146717
Provider Name: DR. DIANA HEARST IKEDA, PH.D.
Classification: Psychologist - 103TB0200X
Entity Type: Individual

Specialization: Cognitive & Behavioral

Address:
20 TREMONT ST
SUITE 12 A
DUXBURY, MA
ZIP 02332
Phone: (781) 934-6390
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DR. Diana Hearst Ikeda, PH.D. is a cognitive and behavioral psychologist in Duxbury, MA. The provider is a psychologist who reflects an experimental-clinical approach distinguished by use of principles of human learning and development and theories of cognitive processing to promote meaningful change in maladaptive human behavior and thinking. DR. Diana Hearst Ikeda, PH.D. NPI is 1124146717. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

20 TREMONT ST
SUITE 12 A
DUXBURY, MA
ZIP 02332-310
Phone: (781) 934-6390
Fax: (781) 934-9991

The enumeration date for this NPI number is 3/26/2007 and was last updated on 12/13/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	6917	MASSACHUSETTS	No
2	101YM0800X	Counselor	Mental Health	6917	MASSACHUSETTS	No
3	103T00000X	Psychologist		6917	MASSACHUSETTS	No
4	103TA0400X	Psychologist	Addiction (Substance Use Disorder)	6917	MASSACHUSETTS	No
5	103TA0700X	Psychologist	Adult Development & Aging	6917	MASSACHUSETTS	No
6	103TC0700X	Psychologist	Clinical	6917	MASSACHUSETTS	No
7	103TC1900X	Psychologist	Counseling	6917	MASSACHUSETTS	No
8	103TC2200X	Psychologist	Clinical Child & Adolescent	6917	MASSACHUSETTS	No
9	103TF0000X	Psychologist	Family	6917	MASSACHUSETTS	No
10	103TB0200X	Psychologist	Cognitive & Behavioral	6917	MASSACHUSETTS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	W05611	OTHER	MASSACHUSETTS	BLUE CROSS BLUE SHIELD
2	W05211	MEDICARE ID-TYPE UNSPECIFIED	MASSACHUSETTS
3	407109	OTHER	MASSACHUSETTS	TUFTS BEHAVIORAL HEALTH
4	W05211	MEDICAID	MASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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