Individual provider Active NPI

Thomas M Medlar, LMHC

  • Mental Health Counselor
  • West Springfield, MA
National Provider Identifier
1114957412
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1513 Issued in MA
Practice address
1132 Westfield St
West Springfield, MA 01089-3878
Phone
(413) 592-1980
Fax
(413) 439-0096
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 746 MA
Mental Health Counselor 101YM0800X 1513 MA Primary

Addresses

Primary practice location

1132 Westfield St
West Springfield, MA 01089-3878

Mailing address

5 Taylor Way
Middleboro, MA 02346-2500
Phone (508) 947-3561

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
I20240131003969 MA Practitioner - Mental Health Counselor 3173976651 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
746MAMDMarriage & Family Therapist
1513MAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthdrive Behavioral Health Services, PLLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

100 Crossing Blvd
Ste 300
Framingham, MA 01702
Phone (857) 255-0486

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.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1114957412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 TAYLOR WAY",
            "city": "MIDDLEBORO",
            "state": "MA",
            "postal_code": "023462500",
            "telephone_number": "508-947-3561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1132 WESTFIELD ST",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "010893878",
            "telephone_number": "413-592-1980",
            "fax_number": "413-439-0096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDLAR",
        "first_name": "THOMAS",
        "middle_name": "M",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MA",
            "license": "746",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "1513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Springfield, MA

Sources for this page

Verify at the official NPI Registry.