Jennifer Hatalla

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

10574 Issued in MA

Practice address

500 W Cummings Park
Woburn, MA 01801-6503

Phone

(781) 932-0970

Fax

(781) 932-0218

NPI assigned

Aug 25, 2014

Last updated

Oct 25, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1408924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1255731550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100A HAVERHILL ST",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018444251",
            "telephone_number": "978-682-5276",
            "fax_number": "781-848-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W CUMMINGS PARK",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018016503",
            "telephone_number": "781-932-0970",
            "fax_number": "781-932-0218"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100A Haverhill St",
            "address_purpose": "LOCATION",
            "city": "Methuen",
            "state": "MA",
            "postal_code": "018444251",
            "country_code": "US",
            "telephone_number": "978-682-5276",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HATALLA",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-25",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "10574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10574",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Stephanie Harvey
• Christian John Hashem
• Katie Nee Hathaway, COTA/L
• Scott E Havemeyer, P.T.
• Aiden Hawker
• Ashley Hayden
• Barbara L Hayes

• Mental Health Counselor in Woburn, MA
• Providers in Woburn, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; 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.