| Virginia M Shiller, Ph.d., Llc | |
|
55 Watertown St Unit 460 Lexington MA 02421-6358 | |
| (203) 415-7160 | |
| (203) 776-3681 |
| Full Name | Virginia M Shiller, Ph.d., Llc |
|---|---|
| Speciality | Psychologist |
| Location | 55 Watertown St Unit 460, Lexington, Massachusetts |
| Authorized Official Name and Position | Virginia M Shiller (MEMBER) |
| Authorized Official Contact | 2037763681 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Virginia M Shiller, Ph.d., Llc 55 Watertown St Unit 460 Lexington MA 02421-6358 Ph: (203) 415-7160 | Virginia M Shiller, Ph.d., Llc 55 Watertown St Unit 460 Lexington MA 02421-6358 Ph: (203) 415-7160 |
| NPI Number | 1285927871 |
|---|---|
| Provider Enumeration Date | 05/16/2011 |
| Last Update Date | 09/08/2025 |
| Certification Date | 09/08/2025 |
| Medicare PECOS PAC ID | 7113105479 |
|---|---|
| Medicare Enrollment ID | O20110711000244 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285927871 | NPI | - | NPPES |
| 004065801 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 1236 (Connecticut) | Primary |
| Provider Name | Virginia Marie Shiller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1053460139 PECOS PAC ID: 0941478028 Enrollment ID: I20110715000028 |
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