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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

GENESIS VERGARA PHD
NPI 1215636915
Psychologist - Clinical in Revere, MA

Active since March 01, 2023
300 OCEAN AVE, REVERE, MA 02151(781) 485-6100 Get Directions Write a Review

NPPES record last updated: September 14, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Sep 14, 2026, Mar 1, 2023 (2 updates tracked since 2023).

About Genesis Vergara Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GENESIS VERGARA PHD (NPI 1215636915) is an individual clinical provider in Revere, Massachusetts, licensed in Massachusetts (PSY10001870) and active in the NPI registry since March 2023.

NPPES Registry Identity

NPI1215636915
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameGENESIS VERGARACredential: PHD
Location Address300 OCEAN AVERevere, MA 02151-3675
Mailing Address300 Ocean AveRevere, MA 02151-3675 · (781) 485-6100
Phone(781) 485-6100
Sole ProprietorNo
Enumeration DateMarch 1, 2023
Last NPPES UpdateSeptember 14, 20262 updates tracked since enumeration
NPPES CertifiedSeptember 14, 2026
✔ NPI 1215636915 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in MA · PSY10001870
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
300 OCEAN AVE, Revere, MA 02151
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. STACIE ANN HOBAN MS, CCC-SLP
Speech-Language Pathologist
300 OCEAN AVE, SPEECH AND LANGUAGE
REVERE, MA 02151
Suffolk County (781) 485-6131
DANYA HANDELSMAN
Student in an Organized Health Care Education/Training Program
300 OCEAN AVE
REVERE, MA 02151
Suffolk County (781) 485-6000
MS. EMILY J WILCOX NP
Nurse Practitioner (Pediatrics)
300 OCEAN AVE
REVERE, MA 02151
Suffolk County (781) 485-6000
CECILIA JIANG
Physical Therapist
300 OCEAN AVE
REVERE, MA 02151
Suffolk County (781) 485-6234
ELLEN TIGHE VENTOLA MS,PT,OCS
Specialist
300 OCEAN AVE
REVERE, MA 02151
Suffolk County (781) 485-6222
EMILY CARUSO MACINTYRE CPNP
Nurse Practitioner (Pediatrics)
300 OCEAN AVE
REVERE, MA 02151
Suffolk County (781) 485-6024
DR. JOSEPH MICHAEL CZUPRYNA DPT
Physical Therapist
300 OCEAN AVE
REVERE, MA 02151
Suffolk County (781) 485-6000
JESSICA BRYSKI
Student in an Organized Health Care Education/Training Program
300 OCEAN AVE
REVERE, MA 02151
Suffolk County (307) 399-0688

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Genesis Vergara's NPI number?

The NPI number for Genesis Vergara is 1215636915. It was assigned to this individual provider in the NPPES registry on March 1, 2023.

Where is Genesis Vergara located?

Genesis Vergara practices at 300 Ocean Ave, Revere, MA 02151. The listed phone number is (781) 485-6100.

What is Genesis Vergara's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Genesis Vergara was last updated on September 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.