Organization Active NPI

Safe Space Therapeutic Services, Inc.

  • Mental Health Counselor
  • Randolph, MA
National Provider Identifier
1063044774
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
SAFE SPACE THERAPEUTIC SERVICES, INC.
Practice address
10 Mazzeo Dr Ste 206
Randolph, MA 02368-3433
Phone
(781) 269-2774
Fax
(781) 394-8377
NPI assigned
Feb 10, 2020
Last updated
Feb 10, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

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

Authorized official

Name
Mrs. Joi Allen-Baaqee, LMHC
Title
President
Phone
(781) 910-3235

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

10 Mazzeo Dr Ste 206
Randolph, MA 02368-3433

Mailing address

5 Pacella Park Dr Apt 6310
Randolph, MA 02368-1794
Phone (781) 910-3235

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241218000032 MA Part B Supplier - Clinic/Group Practice 5294262085 Receives reassigned benefits from 1 practitioner
Practice locations: Randolph, MA

National Provider Directory

National Provider Directory

Locations

10 Mazzeo Dr
Ste 206
Randolph, MA 02368
Phone (781) 269-2774

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581292800000",
    "number": "1063044774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 PACELLA PARK DR APT 6310",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023681794",
            "telephone_number": "781-910-3235",
            "fax_number": "781-394-8377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MAZZEO DR STE 206",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023683433",
            "telephone_number": "781-269-2774",
            "fax_number": "781-394-8377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFE SPACE THERAPEUTIC SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-10",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A",
        "authorized_official_last_name": "ALLEN-BAAQEE",
        "authorized_official_first_name": "JOI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-910-3235",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randolph, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.