Organization Active NPI

New Beginnings of Southbridge

  • Marriage & Family Therapist
  • Southbridge, MA
National Provider Identifier
1215455829
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1186 Issued in MA
Legal business name
NEW BEGINNINGS OF SOUTHBRIDGE
Practice address
146 Ashland Ave Suite B
Southbridge, MA 01550
Phone
(774) 318-1806
NPI assigned
Sep 3, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Samuel W Young, DMIN
Title
FSS Clinician
Phone
(774) 318-1806

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X 1186 MA Primary

Addresses

Primary practice location

146 Ashland Ave Suite B
Southbridge, MA 01550

Mailing address

146 Ashland Ave Suite B
Southbridge, MA 01550
Phone (774) 318-1806

Other identifiers 2

IdentifierTypeStateIssuer
1186OtherMALMFT
1186OtherMALICENSE

National Provider Directory

National Provider Directory

Locations

146 Ashland Ave
Ste B
Southbridge, MA 01550
Phone (774) 318-1806

NPI Registry JSON

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

{
    "created_epoch": "1504396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1215455829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 ASHLAND AVE SUITE B",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "01550",
            "telephone_number": "774-318-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 ASHLAND AVE SUITE B",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "01550",
            "telephone_number": "774-318-1806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW BEGINNINGS OF SOUTHBRIDGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-03",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "FSS CLINICIAN",
        "authorized_official_telephone_number": "774-318-1806",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMIN"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "MA",
            "license": "1186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMFT",
            "identifier": "1186",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "1186",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southbridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.