Individual provider Active NPI

Noah Slater

  • Mental Health Counselor
  • Norwell, MA
National Provider Identifier
1134618846
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
200 Cordwainer Dr Ste 200
Norwell, MA 02061-1671
Phone
(781) 878-8340
Fax
(339) 788-9904
NPI assigned
May 8, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LICSW127628 MA
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

200 Cordwainer Dr Ste 200
Norwell, MA 02061-1671

Mailing address

200 Cordwainer Dr Ste 200
Norwell, MA 02061-1671
Phone (781) 878-8340

Other practice location 1

680 Centre St
Brockton, MA 02302-3308
Phone (508) 941-7851

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
I20250430002845 MA Practitioner - Clinical Social Worker 0042736233 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LICSW127628MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Second Wave Counseling LLC Clinical Current Accepting new patients
Brockton Hospital, Inc. CurrentSince Feb 27, 2025 Accepting new patients
Brockton Hospital, Inc. CurrentSince Feb 27, 2025 Accepting new patients
Signature Healthcare Medical Group Inc CurrentSince Aug 1, 2025 Accepting new patients
South Shore Center for Wellness LTD PastSince Sep 24, 2013 Accepting new patients

Locations

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

Organizations & group practices 5

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": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1134618846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORDWAINER DR STE 200",
            "city": "NORWELL",
            "state": "MA",
            "postal_code": "020611671",
            "telephone_number": "781-878-8340",
            "fax_number": "339-788-9904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CORDWAINER DR STE 200",
            "city": "NORWELL",
            "state": "MA",
            "postal_code": "020611671",
            "telephone_number": "781-878-8340",
            "fax_number": "339-788-9904"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "680 Centre St",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023023308",
            "country_code": "US",
            "telephone_number": "508-941-7851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SLATER",
        "first_name": "NOAH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-08",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "LICSW127628",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwell, MA

Sources for this page

Verify at the official NPI Registry.