Individual provider Active NPI

Shawn Daley

  • Mental Health Counselor
  • Springfield, MA
National Provider Identifier
1316089725
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6920 Issued in MA
Practice address
511 E Columbus Ave
Springfield, MA 01105-2506
Phone
(413) 827-8959
Fax
(413) 827-7015
NPI assigned
Feb 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6920 MA Primary
Clinical Social Worker 1041C0700X

Addresses

Primary practice location

511 E Columbus Ave
Springfield, MA 01105-2506

Mailing address

63 Malden St
Worcester, MA 01606-1005
Phone (413) 827-8959

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
I20231222000102 MA Practitioner - Mental Health Counselor 2860842457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Health Services LLCGroup PAC ID 6901866706, 470 clinicians

Practice addresses (Care Compare)

8 N Main St
5TH FL
Attleboro, MA 02703-2282
Phone (508) 409-0000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6920MAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Health Services, LLC CurrentSince Jan 1, 2024 Accepting new patients
Northeast Health Services PastSince Jan 1, 2024 Accepting new patients

Locations

8 N Main St
Fl 5
Attleboro, MA 02703
Phone (508) 217-7282

30 Taunton Grn
Ste 5
Taunton, MA 02780
Phone (508) 545-7400

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1316089725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 MALDEN ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016061005",
            "telephone_number": "413-827-8959",
            "fax_number": "413-827-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 E COLUMBUS AVE",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011052506",
            "telephone_number": "413-827-8959",
            "fax_number": "413-827-7015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALEY",
        "first_name": "SHAWN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "6920",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.