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Deactivated NPI 1730230145 Deactivated / Inactive NPI Female Practitioner

Dr. Carolyn Stack , PsyD

Psychologist • Cambridge, MA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Carolyn Stack has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 13, 2007
NPI Deactivation Date May 01, 2025
Total Practice Duration ~18 Years of Practice (2007 – 2025)

Professional Overview & Biography Verified Profile Summary

Dr. Carolyn Stack, PsyD was a registered Psychologist practicing in Cambridge, MA. Throughout an active medical career spanning 18 years, Dr. Stack provided care at the practice location at 129 MOUNT AUBURN ST until profile deactivation on 2025-05-01.

Practice Location & Contact Primary Location

Practice Address

129 Mount Auburn St

Cambridge, MA 021385766

Telephone 6178640765
Associated Practice Facility / Clinic
🏢 Steven I. Brown Dcpc Facility NPI 1225235989

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist in Cambridge, MA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 28.7 Yrs
State Avg: 32.3 Yrs
Regional Practice Density
197 Specialists

Practicing in Cambridge, MA (2533 Statewide)

Telehealth Adoption Rate
8.1% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

State License MA 6571

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
Dr. Rita Teusch , PhD

Psychologist - Clinical

NPI 1003965583

Doctor of Philosophy (Ph.D.)

Matthew Gomes

Student in an Organized Health Care Education/Training Program

NPI 1245190149
Leon Latino

Counselor - Mental Health

NPI 1316864085
NPI 1477554319

Doctor of Chiropractic

NPI 1780749705

Doctor of Education (Ed.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated May 01, 2025

Record deactivated on May 01, 2025

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 129 MOUNT AUBURN ST, CAMBRIDGE, MA 021385766 (Tel: 6178640765)

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Updated Business Mailing Address July 08, 2007

Registered at 154 CHILTON ST, CAMBRIDGE, MA 021381227 (Tel: 6178767785)

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Provider Name / Credentials Updated July 08, 2007

Recorded as CAROLYN STACK, PSY.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Psychologist (License #6571 in MA)

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Initial NPI Registration & Enumeration January 13, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1730230145
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 13, 2007
Last Update: July 08, 2007
Deactivation Date: May 01, 2025

Mailing Address

154 Chilton St

Cambridge, MA 021381227

Phone: 6178767785

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

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