Active NPI
Carol A. Wayne, LMHC, LMFT
- Mental Health Counselor
- Jamaica Plain, MA
National Provider Identifier
1063557965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 329 AND 560
- Practice address
- 157 Green St
Jamaica Plain, MA 02130-2667 - Phone
- (617) 983-5828
- Fax
- (617) 983-5840
- NPI assigned
- Feb 20, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 329 AND 560 | MA | Primary |
Addresses
Primary practice location
157 Green St
Jamaica Plain, MA 02130-2667
Mailing address
362 Tappan St
Brookline, MA 02445-5352
Phone (617) 983-5828
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 329 AND 560 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063557965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "362 TAPPAN ST",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024455352",
"telephone_number": "617-983-5828",
"fax_number": "617-983-5840"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "157 GREEN ST",
"city": "JAMAICA PLAIN",
"state": "MA",
"postal_code": "021302667",
"telephone_number": "617-983-5828",
"fax_number": "617-983-5840"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAYNE",
"first_name": "CAROL",
"middle_name": "A.",
"name_prefix": "Mrs.",
"credential": "LMHC, LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "329 AND 560",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jamaica Plain, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.