Individual provider Active NPI

Jessica Dalzell

  • Mental Health Counselor
  • Marlborough, MA
National Provider Identifier
1093472888
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
340 Maple St Ste 400
Marlborough, MA 01752-3200
Phone
(508) 485-9300
NPI assigned
Nov 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

340 Maple St Ste 400
Marlborough, MA 01752-3200

Mailing address

4 Elm St
Hubbardston, MA 01452-1220
Phone (508) 736-3854

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
I20240627000683 MA Practitioner - Mental Health Counselor 9234673609 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Rollins Counseling Center LLCGroup PAC ID 8426460908, 13 clinicians

Practice addresses (Care Compare)

70 Broadway St
Westford, MA 01886-2148
Phone (978) 999-2165

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advocates, Inc. CurrentSince May 20, 2024 Accepting new patients
Advocates, Inc CurrentSince May 20, 2024 Accepting new patients
Rollins Counseling Center LLC CurrentSince Aug 27, 2024 Accepting new patients

Locations

1094 Worcester Rd
Framingham, MA 01702
Phone (508) 665-4344

1881 Worcester Rd
Framingham, MA 01701

340 Maple St
Ste 400
Marlborough, MA 01752
Phone (508) 485-9300

70 Broadway St
Westford, MA 01886
Phone (978) 337-3676

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": "1638144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1093472888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 ELM ST",
            "city": "HUBBARDSTON",
            "state": "MA",
            "postal_code": "014521220",
            "telephone_number": "508-736-3854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 MAPLE ST STE 400",
            "city": "MARLBOROUGH",
            "state": "MA",
            "postal_code": "017523200",
            "telephone_number": "508-485-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALZELL",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-29",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlborough, MA

Sources for this page

Verify at the official NPI Registry.