Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Makiko Watanabe

Individual provider Clinical Psychologist · NPI 1073138442

Makiko Watanabe is a Clinical Psychologist in Boston, Massachusetts. Qualified in 2020, 6 years ago. Practices with The General Hospital Corporation, a 1,276-clinician group and accepts Medicare assignment. Licensed in Massachusetts.

Years since qualifying
6
Licensed in
MA
In the registry since
2020
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Practice location Address checks out

55 Fruit St
Boston, MA 02114-2696
Phone: (617) 724-6300
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 11579 (MA)

Record details

NPI number1073138442
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 11, 2020
Last updated in NPPESFebruary 2, 2022
Certification dateFebruary 2, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice The General Hospital Corporation — 1276 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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