NPIMap

Individual provider Active NPI

Daniel Mendes Depina, M.ED. LADC I, MA PG

  • Addiction (Substance Use Disorder) Counselor
  • Brockton, MA
National Provider Identifier
1073817573
Registry record updated Aug 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
682 North Main Street
Apt. 308
Brockton, MA 02301-3626
Phone
(508) 857-9058
NPI assigned
Dec 27, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

682 North Main Street
Apt. 308
Brockton, MA 02301-3626

Mailing address

682 North Main Street
Apt. 308
Brockton, MA 02301-3626
Phone (508) 857-9058

Other practice location 1

1311 Main St
Brockton, MA 02301-7109
Phone (508) 256-3238

Other practice location 2

1305 Main St
Brockton, MA 02301-7109
Phone (508) 256-3238

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ddepina@tcclinicalgroup.org Health Information Exchange (HIE)

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

Practice roles

OrganizationSpecialtyStatusNew patients
Teen Challenge New England Inc PastSince Dec 22, 2020 Accepting new patients

Organizations & group practices 1

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": "1293408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596758400000",
    "number": "1073817573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "682 NORTH MAIN STREET",
            "address_2": "APT. 308",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023013626",
            "telephone_number": "508-857-9058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "682 NORTH MAIN STREET",
            "address_2": "APT. 308",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023013626",
            "telephone_number": "508-857-9058"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1311 Main St",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023017109",
            "country_code": "US",
            "telephone_number": "508-256-3238",
            "fax_number": "508-256-3242",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1305 Main St",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023017109",
            "country_code": "US",
            "telephone_number": "508-256-3238",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEPINA",
        "first_name": "DANIEL",
        "middle_name": "MENDES",
        "name_prefix": "Mr.",
        "credential": "M.ED. LADC I,  MA PG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-12-27",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ddepina@tcclinicalgroup.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1311 Main St",
            "city": "Brockton",
            "state": "MA",
            "country_code": "US",
            "postal_code": "023017109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.