Individual provider Active NPI

Allison Faeryn Verlee, LICSW

  • Mental Health Counselor
  • Salem, MA
National Provider Identifier
1053833533
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
124091 Issued in MA
Practice address
25 Andrew St
Unit 3
Salem, MA 01970
Phone
(978) 924-4209
Fax
(978) 224-5877
NPI assigned
Jul 17, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X
Mental Health Counselor 101YM0800X 124091 MA Primary

Addresses

Primary practice location

25 Andrew St
Unit 3
Salem, MA 01970

Mailing address

25 Andrew St.
Unit 3
Salem, MA 01970
Phone (857) 337-9247

Other names 1

  • Allison Nicole Roberts 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
I20250915000104 MA Practitioner - Clinical Social Worker 9335642354 Practice locations: Salem, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4 Cousins St
Apt 3
Salem, MA 01970-5229

4 Cousins St
Apt 3
Salem, MA 01970-5356
Phone (978) 924-4209

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
124091MAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1500249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1053833533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 ANDREW ST.",
            "address_2": "UNIT 3",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "01970",
            "telephone_number": "857-337-9247",
            "fax_number": "978-224-5877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 ANDREW ST",
            "address_2": "UNIT 3",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "01970",
            "telephone_number": "978-924-4209",
            "fax_number": "978-224-5877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERLEE",
        "first_name": "ALLISON",
        "middle_name": "FAERYN",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-17",
        "last_updated": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "124091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALLISON",
            "last_name": "ROBERTS",
            "middle_name": "NICOLE",
            "credential": "LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salem, MA

Sources for this page

Verify at the official NPI Registry.