Mill Pond Counseling LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

MILL POND COUNSELING LLC

Practice address

40 Accord Park Dr Ste A110
Norwell, MA 02061-1613

Phone

(781) 435-7941

NPI assigned

Jun 20, 2020

Organization subpart

No

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

Authorized official

Name

Jonathan Blaisdell, MANPI 1609292192

Title

Owner

Phone

(781) 435-7941

Specialties & licenses 6

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jonathan Blaisdell, M.A.

  • Mental Health Counselor
  • Norwell, MA
  • NPI 1609292192

  Counselor

  NPD Authorized official

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

{
    "created_epoch": "1592611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662508800000",
    "number": "1285250795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 ACCORD PARK DR STE A110",
            "city": "NORWELL",
            "state": "MA",
            "postal_code": "020611613",
            "telephone_number": "781-435-7941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 ACCORD PARK DR STE A110",
            "city": "NORWELL",
            "state": "MA",
            "postal_code": "020611613",
            "telephone_number": "781-435-7941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILL POND COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-20",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A",
        "authorized_official_last_name": "BLAISDELL",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-435-7941",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna T Micci, LICSW
• Daniel Michaelson, DC
• Michol Negron DO, PC
• Bret Middlekauff
• Kaleb Matthew Mikami, MD
• Andrea Jean Miller, NP
• Gabrielle Patrice Carroll Millins, LICSW
• Jennifer Hope Milne, MS, CCC-SLP
• Teri Lou Miner, DO
• Tenley Simmons Mirza, CNS LDN

• All providers in Norwell, MA
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; 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.