Active NPI
Inderjit Rangamohan
- Addiction (Substance Use Disorder) Counselor
- Brockton, MA
National Provider Identifier
1336390376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- C0600052
- Practice address
- 180 Centre St
Brockton, MA 02302-2733 - Phone
- (508) 586-6300
- NPI assigned
- Oct 8, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | C0600052 | OH | Primary |
| Mental Health Counselor | 101YM0800X | C0600052 | OH |
Addresses
Primary practice location
180 Centre St
Brockton, MA 02302-2733
Mailing address
95 W Squantum St
Apt 718
North Quincy, MA 02171-2123
Phone (617) 302-4360
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C0600052 | OH | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1223424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1223424000000",
"number": "1336390376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "95 W SQUANTUM ST",
"address_2": "APT 718",
"city": "NORTH QUINCY",
"state": "MA",
"postal_code": "021712123",
"telephone_number": "617-302-4360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "180 CENTRE ST",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023022733",
"telephone_number": "508-586-6300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANGAMOHAN",
"first_name": "INDERJIT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-08",
"last_updated": "2008-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "C0600052",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "C0600052",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brockton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.