Active NPI
New Beginnings of Southbridge
- Marriage & Family Therapist
- Southbridge, MA
National Provider Identifier
1215455829
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 1186
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1186 | Other | MA | LMFT |
| 1186 | Other | MA | LICENSE |
National Provider Directory
National Provider DirectoryLocations
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.