Individual provider Active NPI

Dorothy Mack

  • Counselor
  • Pittsfield, MA
National Provider Identifier
1356623755
Registry record updated Sep 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
359 Fenn St
Administrative Offices
Pittsfield, MA 01201-5261
Phone
(413) 629-1262
Fax
(413) 448-2198
NPI assigned
Sep 13, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

359 Fenn St
Administrative Offices
Pittsfield, MA 01201-5261

Mailing address

359 Fenn St
Administrative Offices
Pittsfield, MA 01201-5261
Phone (413) 629-1262

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
I20190108003680 MA Practitioner - Clinical Social Worker 6002152261 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

222 S St
Pittsfield, MA 01201-6877
Phone (413) 281-0141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dorothy Mack, Licsw LLC CurrentSince Jun 16, 2021 Accepting new patients

Locations

222 South St
Pittsfield, MA 01201
Phone (413) 281-0141

Organizations & group practices 1

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": "1315872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315872000000",
    "number": "1356623755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "359 FENN ST",
            "address_2": "ADMINISTRATIVE OFFICES",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012015261",
            "telephone_number": "413-629-1262",
            "fax_number": "413-448-2198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "359 FENN ST",
            "address_2": "ADMINISTRATIVE OFFICES",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012015261",
            "telephone_number": "413-629-1262",
            "fax_number": "413-448-2198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "DOROTHY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-13",
        "last_updated": "2011-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsfield, MA

Sources for this page

Verify at the official NPI Registry.