Genesis Vergara, PHD
Psychologist, Clinical in Revere, Massachusetts
1215636915- Practice location
- 300 Ocean Ave, Revere, MA 02151-3675
- Phone
- 781-485-6100
- Fax
- —
- Last updated
- September 14, 2026
Genesis Vergara is a Psychologist, Clinical based in Revere, MA. Genesis Vergara practices in Revere, MA and has the professional credentials of PHD. The NPI Number for Genesis Vergara is 1215636915 and holds a License No. PSY10001870 (MA). The current practice location address for Genesis Vergara is 300 Ocean Ave, Revere, MA 02151-3675 and can be reached out via phone at 781-485-6100.
Provider Profile Details
- NPI Number
- 1215636915
- Provider Name
- Genesis Vergara
- Credential
- PHD
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 300 Ocean Ave, Revere, MA 02151-3675
- Phone Number
- 781-485-6100
- Primary Taxonomy
- Psychologist, Clinical · 103TC0700X
- Sole Proprietor
- No
- Provider Enumeration Date
- March 1, 2023
- Last Update Date
- September 14, 2026
- Certification Date
- September 14, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 300 Ocean Ave
Revere, MA 02151-3675 - City
- Revere
- State
- Massachusetts
- Zip
- 02151-3675
- Phone Number
- 781-485-6100
Provider Business Mailing Address Details
- Address
- 300 Ocean Ave
Revere, MA 02151-3675 - City
- Revere
- State
- MA
- Zip
- 02151-3675
- Phone Number
- 781-485-6100
License Information
- License Number
- PSY10001870
- License State
- MA
- Taxonomy
- Psychologist, Clinical · 103TC0700X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Genesis Vergara, PHD?
The NPI number of Genesis Vergara, PHD is 1215636915. It was assigned on March 1, 2023 and is currently active in the NPPES registry.
What is the specialty of Genesis Vergara, PHD?
Genesis Vergara, PHD is registered under the primary taxonomy Psychologist, Clinical (code 103TC0700X), licensed in MA under license number PSY10001870.
Where does Genesis Vergara, PHD practice?
The practice location is 300 Ocean Ave, Revere, MA 02151-3675. The office can be reached at 781-485-6100 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1215636915 directly on the NPPES registry website.