Individual provider Active NPI

Virginia Sherwood, PHD

  • Mental Health Counselor
  • Concord, MA
National Provider Identifier
1366678609
Registry record updated Nov 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
97 Lowell Rd
Concord, MA 01742-1733
Phone
(978) 254-1101
Fax
(781) 259-4111
NPI assigned
Jun 1, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2016

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

97 Lowell Rd
Concord, MA 01742-1733

Mailing address

97 Lowell Rd
Concord, MA 01742-1733
Phone (978) 254-1101

Other identifiers 1

IdentifierTypeStateIssuer
110027776BMedicaidMA

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
I20240319002325 MA Practitioner - Mental Health Counselor 2860839412 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
8169MAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Martha'S Vineyard Community Services, Inc. Mental Health CurrentSince Feb 6, 2024 Accepting new patients

Locations

111 Edgartown Vineyard Haven Rd
Vineyard Hvn, MA 02568

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": "1243814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479772800000",
    "number": "1366678609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 LOWELL RD",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017421733",
            "telephone_number": "978-254-1101",
            "fax_number": "781-259-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 LOWELL RD",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017421733",
            "telephone_number": "978-254-1101",
            "fax_number": "781-259-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERWOOD",
        "first_name": "VIRGINIA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-01",
        "last_updated": "2016-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110027776B",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, MA

Sources for this page

Verify at the official NPI Registry.