Active NPI
Jiabao Gao
- Mental Health Counselor
- Quincy, MA
National Provider Identifier
1255713848
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 859 Willard St
Quincy, MA 02169-7482 - Phone
- (617) 847-1950
- Fax
- (617) 774-1490
- NPI assigned
- Jun 19, 2015
- Last updated
- Jun 24, 2015
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
859 Willard St
Quincy, MA 02169-7482
Mailing address
859 Willard St
Quincy, MA 02169-7482
Phone (617) 847-1950
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 10, 2026 through Jan 10, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435104000000",
"number": "1255713848",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "859 WILLARD ST",
"city": "QUINCY",
"state": "MA",
"postal_code": "021697482",
"telephone_number": "617-847-1950",
"fax_number": "617-774-1490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "859 WILLARD ST",
"city": "QUINCY",
"state": "MA",
"postal_code": "021697482",
"telephone_number": "617-847-1950",
"fax_number": "617-774-1490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAO",
"first_name": "JIABAO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-19",
"last_updated": "2015-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Quincy, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.