Individual provider Active NPI

Marissa Intravia Loring, M.A., R-DMT, LMHC

  • Mental Health Counselor
  • Brockton, MA
National Provider Identifier
1275889180
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
10 Meadowbrook Rd
Brockton, MA 02301-7122
Phone
(508) 264-1418
NPI assigned
Jul 29, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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 Primary

Addresses

Primary practice location

10 Meadowbrook Rd
Brockton, MA 02301-7122

Mailing address

10 Meadowbrook Rd
Brockton, MA 02301-7122

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
I20240402001888 MA Practitioner - Mental Health Counselor 3870931488 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
High Point Treatment Center Inc. CurrentSince Mar 19, 2024 Accepting new patients

Locations

10 Meadowbrook Rd
Brockton, MA 02301
Phone (508) 584-9210

30 Meadowbrook Rd
Brockton, MA 02301
Phone (508) 408-6190

72 Kilburn St
New Bedford, MA 02740
Phone (774) 213-8448

1233 State Rd
Plymouth, MA 02360
Phone (508) 224-6527

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1343520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1275889180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 MEADOWBROOK RD",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023017122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MEADOWBROOK RD",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023017122",
            "telephone_number": "508-264-1418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORING",
        "first_name": "MARISSA",
        "middle_name": "INTRAVIA",
        "name_prefix": "Miss",
        "credential": "M.A., R-DMT, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-29",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.