Individual provider Active NPI

Melissa Gonneville

  • Mental Health Counselor
  • Plymouth, MA
National Provider Identifier
1083084917
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LMHC10002073 Issued in MA
Practice address
39A Industrial Park Rd
Plymouth, MA 02360-4868
Phone
(508) 830-1444
NPI assigned
Oct 5, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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 LMHC10002073 MA Primary

Addresses

Primary practice location

39A Industrial Park Rd
Plymouth, MA 02360-4868

Mailing address

39A Industrial Park Rd
Plymouth, MA 02360-4868
Phone (508) 830-1444

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
I20240807000912 MA Practitioner - Mental Health Counselor 7810434982 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Health Services LLCGroup PAC ID 6901866706, 470 clinicians

Practice addresses (Care Compare)

39 A Industrial Park Rd
Plymouth, MA 02360-4868
Phone (508) 830-1444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Health Services, LLC CurrentSince Jul 23, 2024 Accepting new patients
Bridgewater Pediatrics LLC PastSince May 8, 2022 Accepting new patients
Northeast Health Services Past Accepting new patients

Locations

39A Industrial Park Rd
Plymouth, MA 02360
Phone (508) 534-8048

30 Taunton Grn
Ste 5
Taunton, MA 02780
Phone (508) 545-7400

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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": "1444003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1083084917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39A INDUSTRIAL PARK RD",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023604868",
            "telephone_number": "508-830-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39A INDUSTRIAL PARK RD",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023604868",
            "telephone_number": "508-830-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONNEVILLE",
        "first_name": "MELISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-05",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "LMHC10002073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

Verify at the official NPI Registry.