Individual provider Active NPI

Victoria M Johnson

  • Addiction (Substance Use Disorder) Counselor
  • Chelsea, MA
National Provider Identifier
1316258890
Registry record updated Jun 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
3691 Issued in MA
Practice address
175 Crescent Ave
Chelsea, MA 02150-3009
Phone
(617) 889-8779
NPI assigned
Jun 29, 2010
Last updated
Jun 29, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 3691 MA Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 571 MA

Addresses

Primary practice location

175 Crescent Ave
Chelsea, MA 02150-3009

Mailing address

125 N Elm St
Westfield, MA 01085-1643

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
I20240112000179 MA Practitioner - Mental Health Counselor 3678924867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

929 Mass Ave
Suite 103
Cambridge, MA 02139-3134
Phone (855) 284-7483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
571MAMDAddiction (Substance Use Disorder) Counselor
3691MAMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC CurrentSince Jan 1, 2024 Accepting new patients
Community Physicians PC Past Accepting new patients
Community Health Care, Inc. Addiction (Substance Use Disorder) Past Accepting new patients

Locations

872 Massachusetts Ave
Ste 2-2
Cambridge, MA 02139
Phone (617) 395-5806

929 Massachusetts Ave
Ste 103
Cambridge, MA 02139
Phone (617) 395-5806

Organizations & group practices 3

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": "1277769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277769600000",
    "number": "1316258890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 N ELM ST",
            "city": "WESTFIELD",
            "state": "MA",
            "postal_code": "010851643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 CRESCENT AVE",
            "city": "CHELSEA",
            "state": "MA",
            "postal_code": "021503009",
            "telephone_number": "617-889-8779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "VICTORIA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-29",
        "last_updated": "2010-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "3691",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "571",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chelsea, MA

Sources for this page

Verify at the official NPI Registry.