Active NPI
Samuel Heaney-Balf
- Counselor
- Gloucester, MA
National Provider Identifier
1205231891
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- S89789955
- Practice address
- 15 Brierwood CT
Gloucester, MA 01930-1284 - Phone
- (978) 491-7873
- NPI assigned
- Oct 26, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | S89789955 | MA | Primary |
Addresses
Primary practice location
15 Brierwood CT
Gloucester, MA 01930-1284
Mailing address
15 Brierwood CT
Gloucester, MA 01930-1284
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S89789955 | MA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1414281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414281600000",
"number": "1205231891",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 BRIERWOOD CT",
"city": "GLOUCESTER",
"state": "MA",
"postal_code": "019301284"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 BRIERWOOD CT",
"city": "GLOUCESTER",
"state": "MA",
"postal_code": "019301284",
"telephone_number": "978-491-7873"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEANEY-BALF",
"first_name": "SAMUEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-10-26",
"last_updated": "2014-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MA",
"license": "S89789955",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gloucester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.