Individual provider Active NPI

Jeremiah Morelock, LMFT

  • Marriage & Family Therapist
  • Woburn, MA
National Provider Identifier
1164567459
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT1365 Issued in MA
Practice address
400 Tradecenter Ste 5900
Woburn, MA 01801-7471
Phone
(617) 519-5952
NPI assigned
Feb 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 6098A NC
Marriage & Family Therapist 106H00000X LMFT1365 MA Primary
Professional Counselor 101YP2500X

Addresses

Primary practice location

400 Tradecenter Ste 5900
Woburn, MA 01801-7471

Mailing address

30A Park Dr Unit a
Woburn, MA 01801-2218
Phone (617) 519-5952

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
I20240212000801 MA Practitioner - Marriage and Family Therapist 4486097086 Reassigns benefits to 2 organizations
Practice locations: Woburn, MA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2006
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

400 Tradecenter
Suite 5900
Woburn, MA 01801-7471
Phone (617) 519-5952

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT1365MAMDMarriage & Family Therapist
6098ANCMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Health Services, LLC CurrentSince Jan 1, 2024 Accepting new patients
Mental Health Specialty Group PA Professional CurrentSince Aug 1, 2025 Accepting new patients
Nova Initia Counseling, LLC Past Accepting new patients
The Childrens Home Past Accepting new patients
The Children'S Home Past Accepting new patients

Locations

101 Federal St
Boston, MA 02110
Phone (206) 744-8030

199 Rosewood Dr
Ste 300
Danvers, MA 01923
Phone (978) 291-7066

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 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": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1164567459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30A PARK DR UNIT A",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018012218",
            "telephone_number": "617-519-5952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 TRADECENTER STE 5900",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018017471",
            "telephone_number": "617-519-5952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORELOCK",
        "first_name": "JEREMIAH",
        "name_prefix": "Dr.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "6098A",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MA",
            "license": "LMFT1365",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

Verify at the official NPI Registry.