Mark Dagnall, LMHC, LADC 1, CRC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

9039 Issued in MA

Practice address

75 Amory St
Rear Entrance
Boston, MA 02119-1051

Phone

(857) 399-1915

Fax

(857) 399-1901

NPI assigned

Apr 14, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1271203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437436800000",
    "number": "1083930192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 AMORY ST",
            "address_2": "REAR ENTRANCE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021191051",
            "telephone_number": "857-399-1915",
            "fax_number": "857-399-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 AMORY ST",
            "address_2": "REAR ENTRANCE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021191051",
            "telephone_number": "857-399-1915",
            "fax_number": "857-399-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAGNALL",
        "first_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "LMHC, LADC 1, CRC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-14",
        "last_updated": "2015-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "2411",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "9039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Louise Dagesse
• Allison Dagg
• Linda R Dagi, MD
• Sigal Dagiely, NP
• Brennan Patrick Dagle, MD
• Ibiayi Dagogo-Jack, M.D.
• Elena Daha-Slavkova, LCSW
• Nujud Daham
• Haissam Dahan, DMD
• Shani Dahan, MD

• Mental Health Counselor in Boston, MA
• Providers in Boston, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.