Active NPI
Shantaya Clara Fonseca, M.A.
- Mental Health Counselor
- Weymouth, MA
National Provider Identifier
1073852448
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 541 Main St
Suite 303
Weymouth, MA 02190-1868 - Phone
- (781) 331-7866
- NPI assigned
- Feb 5, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary | ||
| Clinical Social Worker | 1041C0700X |
Addresses
Primary practice location
541 Main St
Suite 303
Weymouth, MA 02190-1868
Mailing address
541 Main Street
Suite 303
Weymouth, MA 02190
Phone (781) 331-7866
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
- Credentials
- Master of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1360022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360022400000",
"number": "1073852448",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "541 MAIN STREET",
"address_2": "SUITE 303",
"city": "WEYMOUTH",
"state": "MA",
"postal_code": "02190",
"telephone_number": "781-331-7866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "541 MAIN ST",
"address_2": "SUITE 303",
"city": "WEYMOUTH",
"state": "MA",
"postal_code": "021901868",
"telephone_number": "781-331-7866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONSECA",
"first_name": "SHANTAYA",
"middle_name": "CLARA",
"name_prefix": "Ms.",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-02-05",
"last_updated": "2013-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Weymouth, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.