Active NPI
Michael K Chan, MA
- Mental Health Counselor
- Tyngsboro, MA
National Provider Identifier
1114812526
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 352 Middlesex Rd
Tyngsboro, MA 01879-1076 - Phone
- (781) 328-1904
- Fax
- (781) 328-4733
- NPI assigned
- Jun 9, 2025
- 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 | Primary |
Addresses
Primary practice location
352 Middlesex Rd
Tyngsboro, MA 01879-1076
Mailing address
373 Highland Ave Apt 323
Somerville, MA 02144-2555
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Counseling Services of Greater Boston | Mental Health | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Mental Health Counselor
- Wakefield, MA
- NPI 1063764876
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1749427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749427200000",
"number": "1114812526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "373 HIGHLAND AVE APT 323",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "021442555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "352 MIDDLESEX RD",
"city": "TYNGSBORO",
"state": "MA",
"postal_code": "018791076",
"telephone_number": "781-328-1904",
"fax_number": "781-328-4733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "MICHAEL",
"middle_name": "K",
"name_prefix": "Mr.",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-06-09",
"last_updated": "2025-06-09",
"certification_date": "2025-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tyngsboro, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.