Individual provider Active NPI

Deborah Ann Gromack, LMHC

  • Mental Health Counselor
  • Quincy, MA
National Provider Identifier
1356852040
Registry record updated Oct 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6604 Issued in MA
Practice address
1245 Hancock St Ste 25
Quincy, MA 02169-4365
Phone
(781) 925-3500
Fax
(781) 925-3505
NPI assigned
Oct 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2017

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 6604 MA Primary

Addresses

Primary practice location

1245 Hancock St Ste 25
Quincy, MA 02169-4365

Mailing address

322 Brookline St Apt 4
Cambridge, MA 02139-4841
Phone (845) 729-0435

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
I20260521000436 MA Practitioner - Mental Health Counselor 4082183835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6604MAMDMental Health Counselor

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": "1508457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508457600000",
    "number": "1356852040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 BROOKLINE ST APT 4",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021394841",
            "telephone_number": "845-729-0435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 HANCOCK ST STE 25",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021694365",
            "telephone_number": "781-925-3500",
            "fax_number": "781-925-3505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROMACK",
        "first_name": "DEBORAH",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-20",
        "last_updated": "2017-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "6604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.