# DR. JOHN MINER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1558380360
- **Gender:** Man
- **Credential:** PSY.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103G00000X | Clinical Neuropsychologist | 4462 | MA | — |
| 103TA0700X | Adult Development & Aging Psychologist | 4462 | MA | — |
| 103TC0700X | Clinical Psychologist | 4462 | MA | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | 4462 | MA | Yes |
| 103TS0200X | School Psychologist | 166523 | MA | — |

## Other

- **Enumeration date:** 07/19/2006
- **Last updated:** 09/11/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0495668 | UNITED BEHAVIORAL HEALTH | MA |
| 05 | — | 0518255 | — | MA |
| 01 | — | 13632 | HANCOCK | MA |
| 01 | — | 732087 | TUFTS HEALTH CARE | MA |
| 01 | — | 7764376 | AETNA | MA |