Individual provider Active NPI

Stephanie Gildea

  • Mental Health Counselor
  • Springfield, MA
National Provider Identifier
1083021810
Registry record updated Jul 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
500 Grayson Dr
Springfield, MA 01119-1656
Phone
(978) 828-4826
NPI assigned
Jul 14, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

500 Grayson Dr
Springfield, MA 01119-1656

Mailing address

500 Grayson Dr
Springfield, MA 01119-1656

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
I20240125000974 MA Practitioner - Mental Health Counselor 9436502564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SB Transitional Sub LLCGroup PAC ID 7911315379, 70 clinicians

Practice addresses (Care Compare)

37 Water St
Suite 1
Wakefield, MA 01880-3044
Phone (508) 521-2200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
South Bay Mental Health Center, Inc. CurrentSince Jan 1, 2024 Accepting new patients
SB Transitional Sub, LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

103 Commercial St
Ste 2
Brockton, MA 02302

1115 W Chestnut St
Brockton, MA 02301
Phone (508) 559-0473

37 Water St
Ste 1
Wakefield, MA 01880
Phone (781) 223-8042

Organizations & group practices 2

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": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405296000000",
    "number": "1083021810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 GRAYSON DR",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011191656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 GRAYSON DR",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011191656",
            "telephone_number": "978-828-4826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILDEA",
        "first_name": "STEPHANIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-14",
        "last_updated": "2014-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.