Douglas Benton
Individual provider Active NPI Mental Health Counselor · Roxbury, MA
NPI 1013244672 · NPPES record last updated Nov 3, 2009
Key facts
- NPI
- 1013244672
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 520 Dudley St
Roxbury, MA 02119-2769 - Phone
- (617) 602-7869
- Fax
- (617) 541-8178
- NPI assigned
- Nov 3, 2009
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
520 Dudley St
Roxbury, MA 02119-2769
Mailing address
520 Dudley St
Roxbury, MA 02119-2769
Phone (617) 602-7869
Other providers in Roxbury, MA
- Jasmine Bell
- David Bennett
- Judana Sandra Bennett
- Adzele Benoit
- Markarius Bentley
- Anna Berestova
- Berthlyn M Bernier
- Hermine Berry
- Lagina Dawn Bickham
- Zachary Biedermann
All providers in Roxbury, MA · Mental Health Counselor in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 3, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.