Active NPI
Jonathan Clayfield
- Mental Health Counselor
- Worcester, MA
National Provider Identifier
1093397150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 3906
- Practice address
- 411 Chandler St
Worcester, MA 01602-3339 - Phone
- (508) 799-0688
- NPI assigned
- Apr 27, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 3906 | MA | Primary |
Addresses
Primary practice location
411 Chandler St
Worcester, MA 01602-3339
Mailing address
411 Chandler St
Worcester, MA 01602-3339
Phone (508) 799-0688
Medicare participation
Medicare enrollment files- 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1619481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619481600000",
"number": "1093397150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "411 CHANDLER ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016023339",
"telephone_number": "508-799-0688"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 CHANDLER ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016023339",
"telephone_number": "508-799-0688"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLAYFIELD",
"first_name": "JONATHAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-27",
"last_updated": "2021-04-27",
"certification_date": "2021-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "3906",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; 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.