DR. JACQUELINE ANNE SAMSON PH.D.
NPI 1467454652
Psychologist - Cognitive & Behavioral in Belmont, MA

Active since June 01, 2005PECOS EnrolledAccepts Medicare Assignment
115 MILL ST, BELMONT, MA 02478(617) 855-3348(617) 855-2936 Get Directions Write a Review

NPPES record last updated: July 9, 2010. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Jacqueline Anne Samson Ph.d. NPPES

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

DR. JACQUELINE ANNE SAMSON PH.D. (NPI 1467454652) is an individual cognitive & behavioral provider in Belmont, Massachusetts, licensed in Massachusetts (4522) and active in the NPI registry since June 2005. She is enrolled in Medicare PECOS and is a graduate of Other (1983).

NPPES Registry Identity

NPI1467454652
Entity TypeIndividualFemale
Primary Taxonomy103TB0200X
Provider Legal NameDR. JACQUELINE ANNE SAMSONCredential: PH.D.
Location Address115 MILL STBelmont, MA 02478-1041
Mailing Address115 Mill StBelmont, MA 02478-1041 · (617) 855-3348 · Fax (617) 855-2936
Fax(617) 855-2936
Sole ProprietorYes
Medical School CMSOtherGraduated 1983
Enumeration DateJune 1, 2005
Last NPPES UpdateJuly 9, 2010
NPI 1467454652 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPsychologist · Cognitive & BehavioralBehavioral Health & Social Service Providers
Taxonomy Code103TB0200X
License Licensed in MA · 4522
Definition

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.

Also ListedPsychologistTaxonomy 103T00000X · License 4522 (MA)
Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License 4522 (MA)
115 MILL ST, Belmont, MA 02478

Other Names 1

Other Name (5)Ms. Jacqueline Anne Samson-jain

Other Identifiers 5

OtherW05381MA · Blue Cross Blue Shield
Other01950MA · Value Options
Other1858807MA · Masshealth
Medicare ID-Type UnspecifiedW05381MA
Other001458MA · Harvard Pilgrim Health Ca

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Jacqueline Anne Samson Ph.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8426174822
PECOS Enrollment IDI20100922001108
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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.

Psychiatry & Neurology (Psychiatry)
115 MILL ST
BELMONT, MA 02478
Psychiatry & Neurology (Addiction Medicine)
115 MILL ST
BELMONT, MA 02478
Psychologist (Clinical)
115 MILL ST
BELMONT, MA 02478
Psychiatry & Neurology (Addiction Psychiatry)
115 MILL ST
BELMONT, MA 02478
Psychiatry & Neurology (Psychiatry)
115 MILL ST
BELMONT, MA 02478
Social Worker (Clinical)
115 MILL ST
BELMONT, MA 02478
Social Worker (Clinical)
115 MILL ST
BELMONT, MA 02478
Psychiatry & Neurology (Psychiatry)
115 MILL ST
BELMONT, MA 02478

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1467454652, enumerated as an "individual" on June 01, 2005.

The provider is located at 115 MILL ST BELMONT, MA 02478 and the phone number is (617) 855-3348.

Psychologist with taxonomy code 103TB0200X and a focus in Cognitive & Behavioral.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Harvard Pilgrim. Please consult your insurance carrier or call the provider to verify.