Provider Demographics
NPI:1225232036
Name:JOCHELSON, CARRIE J (APRN)
Entity type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:J
Last Name:JOCHELSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:867 BOYLESTON STREET
Mailing Address - Street 2:SUITE 500 UNIT 514
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-2774
Mailing Address - Country:US
Mailing Address - Phone:617-797-8228
Mailing Address - Fax:
Practice Address - Street 1:53 LANGLEY RD STE 350
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02459-1908
Practice Address - Country:US
Practice Address - Phone:617-527-1412
Practice Address - Fax:508-987-4894
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN131827101YM0800X, 363LP0808X
MA131827364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA104826OtherMAGELLAN
MA018441OtherPACIFIC CARE
MAPN0247OtherBCBS
MA1013635OtherCIGNA
MA759103OtherTUFTS
MAS08077Medicare UPIN