Individual provider Active NPI

Michelle Lee Fernandes, ME.D. IN MHC

  • Mental Health Counselor
  • Lynn, MA
National Provider Identifier
1043416092
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LMHC9036 Issued in MA
Practice address
95 Pleasant St
Lynn, MA 01901-1524
Phone
(781) 596-9222
Fax
(781) 581-9876
NPI assigned
Jun 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LMHC9036 MA Primary

Addresses

Primary practice location

95 Pleasant St
Lynn, MA 01901-1524

Mailing address

95 Pleasant St
Lynn, MA 01901-1524
Phone (781) 596-9222

Other names 1

  • Ms. Michelle Lee Fernandes Former name

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
I20231221001165 MA Practitioner - Mental Health Counselor 4486004116 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Health Services LLCGroup PAC ID 6901866706, 470 clinicians

Practice addresses (Care Compare)

30 Taunton GRN
Suite 5
Taunton, MA 02780-3243
Phone (508) 880-6666

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMHC9036MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Health Services, LLC CurrentSince Jan 1, 2024 Accepting new patients
Northeast Health Services PastSince Jan 1, 2024 Accepting new patients

Locations

30 Taunton Grn
Ste 5
Taunton, MA 02780
Phone (508) 545-7400

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1043416092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 PLEASANT ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011524",
            "telephone_number": "781-596-9222",
            "fax_number": "781-581-9876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 PLEASANT ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011524",
            "telephone_number": "781-596-9222",
            "fax_number": "781-581-9876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDES",
        "first_name": "MICHELLE",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "ME.D. IN MHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-26",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "LMHC9036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "FERNANDES",
            "middle_name": "LEE",
            "prefix": "MS.",
            "credential": "ME.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lynn, MA

Sources for this page

Verify at the official NPI Registry.