NPIMap

Organization Active NPI

Retrace Counseling Services

  • Clinical Social Worker
  • Pittsfield, MA
National Provider Identifier
1295494300
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
RETRACE COUNSELING SERVICES
Practice address
20 Edgewood Rd
Pittsfield, MA 01201-3306
Phone
(413) 446-7217
NPI assigned
Dec 16, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Authorized official

Name
Khadeejah Hassan, LICSW, LPNNPI 1528381597
Title
Owner
Phone
(413) 446-7217

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary
Home Health Agency 251E00000X

Addresses

Primary practice location

20 Edgewood Rd
Pittsfield, MA 01201-3306

Mailing address

20 Edgewood Rd
Pittsfield, MA 01201-3306
Phone (413) 446-7217

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1639612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714521600000",
    "number": "1295494300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 EDGEWOOD RD",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012013306",
            "telephone_number": "413-446-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 EDGEWOOD RD",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012013306",
            "telephone_number": "413-446-7217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETRACE COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-16",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A",
        "authorized_official_last_name": "HASSAN",
        "authorized_official_first_name": "KHADEEJAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "413-446-7217",
        "authorized_official_credential": "LICSW, LPN"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; 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.