Individual provider Active NPI

Amy Katherine Hubbard, MS, LMHC

  • Mental Health Counselor
  • Gloucester, MA
National Provider Identifier
1184709784
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
7895 Issued in MA
Practice address
630 Western Ave
Gloucester, MA 01930-5120
Phone
(978) 879-7188
Fax
(978) 231-0528
NPI assigned
Oct 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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 7895 MA Primary

Addresses

Primary practice location

630 Western Ave
Gloucester, MA 01930-5120

Mailing address

630 Western Ave
Gloucester, MA 01930-5120
Phone (978) 879-7188

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
I20240716000996 MA Practitioner - Mental Health Counselor 2769927649 Practice locations: Gloucester, MA

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

630 Western Ave
Gloucester, MA 01930-5120
Phone (978) 879-7188

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7895MAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1184709784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 WESTERN AVE",
            "city": "GLOUCESTER",
            "state": "MA",
            "postal_code": "019305120",
            "telephone_number": "978-879-7188",
            "fax_number": "978-231-0528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 WESTERN AVE",
            "city": "GLOUCESTER",
            "state": "MA",
            "postal_code": "019305120",
            "telephone_number": "978-879-7188",
            "fax_number": "978-231-0528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBBARD",
        "first_name": "AMY",
        "middle_name": "KATHERINE",
        "name_prefix": "Mrs.",
        "credential": "MS, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "7895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gloucester, MA

Sources for this page

Verify at the official NPI Registry.