Individual provider Active NPI

Elizabeth Adewale

  • Mental Health Counselor
  • Salem, MA
National Provider Identifier
1134766827
Registry record updated Dec 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
110 Boston St
Salem, MA 01970-1402
Phone
(978) 744-7905
NPI assigned
Dec 2, 2019
Last updated
Dec 2, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Mental Health Counselor 101YM0800X NU Primary
Marriage & Family Therapist 106H00000X NU

Addresses

Primary practice location

110 Boston St
Salem, MA 01970-1402

Mailing address

23 Logan St
Lynn, MA 01902-2251
Phone (617) 990-2211

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
I20250207000100 MA Practitioner - Mental Health Counselor 6002346905 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Justice Resource Institute, IncGroup PAC ID 3274430590, 24 clinicians

Practice addresses (Care Compare)

110 Boston St
Salem, MA 01970-1402
Phone (978) 744-7905

380 Massachusetts Ave
Acton, MA 01720-3743
Phone (978) 264-3619

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Justice Resource Institute, Inc. Multi-Specialty CurrentSince Dec 1, 2024 Accepting new patients
Northeast Health Services, LLC Multi-Specialty CurrentSince Oct 22, 2025 Accepting new patients
Justice Resource Institute, Inc Past Accepting new patients
Driscoll Care Group LLC Multi-Specialty Past Accepting new patients

Locations

380 Massachusetts Ave
Acton, MA 01720
Phone (978) 263-3006

280 Merrimack St
Ste 141
Lawrence, MA 01843
Phone (508) 901-2044

160 Gould St
Ste 300
Needham Heights, MA 02494
Phone (781) 559-4900

110 Boston St
Salem, MA 01970
Phone (781) 592-5691

30 Taunton Grn
Ste 5
Taunton, MA 02780
Phone (508) 545-7400

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1575244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575244800000",
    "number": "1134766827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 LOGAN ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019022251",
            "telephone_number": "617-990-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 BOSTON ST",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019701402",
            "telephone_number": "978-744-7905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADEWALE",
        "first_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-02",
        "last_updated": "2019-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, MA

Sources for this page

Verify at the official NPI Registry.