Provider Demographics
NPI:1922219062
Name:KUPFERBERG JOSS, RHODA CLAIRE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:RHODA
Middle Name:CLAIRE
Last Name:KUPFERBERG JOSS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 CONCORD ST
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:MA
Mailing Address - Zip Code:01741-1523
Mailing Address - Country:US
Mailing Address - Phone:781-765-7456
Mailing Address - Fax:
Practice Address - Street 1:810 CONCORD ST
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:MA
Practice Address - Zip Code:01741-1523
Practice Address - Country:US
Practice Address - Phone:781-765-7456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2014-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7823103T00000X, 103TB0200X, 103TC0700X, 103TH0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA369724OtherMHN TRICARE
MA5506948OtherMEGA LIFE HEALTH
MA1853724Medicaid
MAW06158OtherFED BLUECROSSBLUE SHIELD
MAW06158OtherBLUE CROSS INDEMNITY
MAW06158OtherANTHEM BLUE CROSS
MAW06158OtherMAGELLAN BLUE CROSS
MAW06158OtherBLUE CROSS PPO HMO CHOICE
MAW06158OtherFED BLUECROSSBLUE SHIELD
MAW06158OtherBLUE CROSS PPO HMO CHOICE