Individual provider Active NPI

Mary Alice Laramie, MA

  • Mental Health Counselor
  • Somerville, MA
National Provider Identifier
1124601174
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
12 Tyler St
Somerville, MA 02143-3241
Phone
(781) 752-9499
NPI assigned
Apr 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 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

12 Tyler St
Somerville, MA 02143-3241

Mailing address

12 Tyler St
Somerville, MA 02143-3241
Phone (781) 752-9499

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mlaramie@riversidecc.org

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
I20260331000728 MA Practitioner - Mental Health Counselor 0547745283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

200 Boston Ave
Suite 1925
Medford, MA 02155-4265

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Community Care PastSince May 16, 2021 Accepting new patients
The Guidance Center PastSince May 16, 2021 Accepting new patients

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": "1619568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1124601174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 TYLER ST",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021433241",
            "telephone_number": "781-752-9499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 TYLER ST",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021433241",
            "telephone_number": "781-752-9499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARAMIE",
        "first_name": "MARY ALICE",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-28",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlaramie@riversidecc.org",
            "affiliation": "N",
            "address_1": "12 Tyler St",
            "city": "Somerville",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021433241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

Verify at the official NPI Registry.