Individual provider Active NPI

Matthew C Page-Shelton, M.ED

  • Mental Health Counselor
  • Gardner, MA
National Provider Identifier
1265959159
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
486 Chestnut St Ste 2
Gardner, MA 01440-3050
Phone
(781) 330-1366
NPI assigned
Aug 23, 2017
Last updated
Apr 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

486 Chestnut St Ste 2
Gardner, MA 01440-3050

Mailing address

486 Chestnut St Ste 2
Gardner, MA 01440-3050
Phone (781) 330-1366

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
I20260624000221 MA Practitioner - Mental Health Counselor 4880166362 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

33 Becky Ave
Gardner, MA 01440-1305

486 Chestnut St
Suite 2
Gardner, MA 01440-3050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Education

Practice roles

OrganizationSpecialtyStatusNew patients
Front Line Services, LLC CurrentSince Apr 23, 2023 Accepting new patients

Locations

486 Chestnut St
Ste 2
Gardner, MA 01440
Phone (781) 330-1366

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1503446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682035200000",
    "number": "1265959159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "486 CHESTNUT ST STE 2",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014403050",
            "telephone_number": "781-330-1366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "486 CHESTNUT ST STE 2",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014403050",
            "telephone_number": "781-330-1366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGE-SHELTON",
        "first_name": "MATTHEW",
        "middle_name": "C",
        "credential": "M.ED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-23",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardner, MA

Sources for this page

Verify at the official NPI Registry.