Individual provider Active NPI

Christine Fay, LICSW, LADC I, CADC

  • Clinical Social Worker
  • Dedham, MA
National Provider Identifier
1235790643
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
128678 Issued in MA
Practice address
3 Allied Dr Ste 303
Dedham, MA 02026-6148
Phone
(617) 221-5131
Fax
(781) 459-4698
NPI assigned
Jun 26, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 22943 MA
Addiction (Substance Use Disorder) Counselor 101YA0400X 1899AD MA
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 128678 MA
Clinical Social Worker 1041C0700X 128678 MA Primary

Addresses

Primary practice location

3 Allied Dr Ste 303
Dedham, MA 02026-6148

Mailing address

78 Lincoln St
Dedham, MA 02026-3309
Phone (781) 474-9423

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
I20250204000344 MA Practitioner - Clinical Social Worker 9931635521 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Health Services LLCGroup PAC ID 6901866706, 470 clinicians

Practice addresses (Care Compare)

333 Elm St
Dedham, MA 02026-4530
Phone (781) 214-6590

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
128678MAMDAddiction (Substance Use Disorder) Counselor
1899ADMAMDAddiction (Substance Use Disorder) Counselor
22943MAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Fay Wellness LLC Addiction (Substance Use Disorder) CurrentSince Feb 23, 2025 Accepting new patients
Northeast Health Services, LLC Multi-Specialty CurrentSince Jan 1, 2025 Accepting new patients
Community Health Care, Inc. Addiction (Substance Use Disorder) Past Accepting new patients
HCRC PastSince Apr 20, 2021 Accepting new patients

Locations

333 Elm St
Ste 10
Dedham, MA 02026

3 Allied Dr
Ste 303
Dedham, MA 02026
Phone (617) 645-4819

333 Elm St
Dedham, MA 02026
Phone (781) 214-6590

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 4

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": "1561507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1235790643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 LINCOLN ST",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020263309",
            "telephone_number": "781-474-9423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 ALLIED DR STE 303",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020266148",
            "telephone_number": "617-221-5131",
            "fax_number": "781-459-4698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAY",
        "first_name": "CHRISTINE",
        "credential": "LICSW, LADC I, CADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-26",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "22943",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "1899AD",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "128678",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "128678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dedham, MA

Sources for this page

Verify at the official NPI Registry.