Individual provider Active NPI

Michele Quinlan Clark, LMHC

  • Mental Health Counselor
  • Norwell, MA
National Provider Identifier
1124163860
Registry record updated Aug 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
5757 Issued in MA
Practice address
167 Washington St Ste 42
Norwell, MA 02061-1797
Phone
(617) 372-3733
Fax
(781) 878-8515
NPI assigned
Feb 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2020

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 5757 MA Primary

Addresses

Primary practice location

167 Washington St Ste 42
Norwell, MA 02061-1797

Mailing address

124 Forsyth Dr
Abington, MA 02351-5031
Phone (617) 372-3733

Other names 1

  • Michele Quinlan Former name

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

State licenses

LicenseStateTypeSpecialty
5757MAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598659200000",
    "number": "1124163860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 FORSYTH DR",
            "city": "ABINGTON",
            "state": "MA",
            "postal_code": "023515031",
            "telephone_number": "617-372-3733",
            "fax_number": "781-878-8515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 WASHINGTON ST STE 42",
            "city": "NORWELL",
            "state": "MA",
            "postal_code": "020611797",
            "telephone_number": "617-372-3733",
            "fax_number": "781-878-8515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MICHELE",
        "middle_name": "QUINLAN",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-08-29",
        "certification_date": "2020-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "5757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELE",
            "last_name": "QUINLAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Norwell, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.