Individual provider Active NPI

Kelly Santos-Peterson

  • Mental Health Counselor
  • Plymouth, MA
National Provider Identifier
1336766351
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
225 Water St Ste A210
Plymouth, MA 02360-4062
Phone
(781) 532-3354
NPI assigned
Jun 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

225 Water St Ste A210
Plymouth, MA 02360-4062

Mailing address

225 Water St Ste A210
Plymouth, MA 02360-4062
Phone (508) 237-0225

Other practice location 1

225 Water St Ste A105
Plymouth, MA 02360-4061
Phone (508) 237-0225

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

Practice roles

OrganizationSpecialtyStatusNew patients
Safe Harbor Counseling Current Accepting new patients
Safe Harbor Counseling Mental Health Current Accepting new patients
Northeast Health Services, LLC PastSince Jun 1, 2020 Accepting new patients
Bridgewater Pediatrics LLC PastSince Jun 1, 2020 Accepting new patients

Locations

225 Water St
Ste A105
Plymouth, MA 02360
Phone (508) 233-8257

Interoperability endpoints

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

Organizations & group practices 4

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": "1593129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1336766351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 WATER ST STE A210",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023604062",
            "telephone_number": "508-237-0225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 WATER ST STE A210",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023604062",
            "telephone_number": "781-532-3354"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 Water St Ste A105",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "MA",
            "postal_code": "023604061",
            "country_code": "US",
            "telephone_number": "508-237-0225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTOS-PETERSON",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-26",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; 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.