Individual provider Active NPI

Garrison Cross Woodfield

  • Counselor
  • Somerville, MA
National Provider Identifier
1003334335
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
17 Inner Belt Rd
Somerville, MA 02143
Phone
(617) 629-6790
NPI assigned
Sep 7, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

17 Inner Belt Rd
Somerville, MA 02143

Mailing address

17 Innerbelt Rd
Somerville, MA 02143-4418
Phone (617) 629-6790

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240111002046 MA Practitioner - Mental Health Counselor 1355792565

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vinfen Corporation CurrentSince Jan 1, 2024 Accepting new patients

Locations

950 Cambridge St
Cambridge, MA 02141
Phone (617) 441-1743

40 Church St
Lowell, MA 01852
Phone (978) 458-6282

40 Church St
Fl 1
Lowell, MA 01852

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1504742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1003334335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 INNERBELT RD",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021434418",
            "telephone_number": "617-629-6790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 INNER BELT RD",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "02143",
            "telephone_number": "617-629-6790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODFIELD",
        "first_name": "GARRISON",
        "middle_name": "CROSS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

Verify at the official NPI Registry.