NPIMap

Individual provider Active NPI

Marissa Lee Maki, LMHC

  • Mental Health Counselor
  • Medfield, MA
National Provider Identifier
1366723215
Registry record updated Jan 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
9906 Issued in MA
Practice address
258 Main Street Suite 7
Medfield, MA 02052
Phone
(508) 242-9666
NPI assigned
Sep 6, 2011
Last updated
Jan 13, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 9906 MA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

258 Main Street Suite 7
Medfield, MA 02052

Mailing address

1 Norwell St.
Norfolk, MA 02056
Phone (617) 605-1715

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

LicenseStateTypeSpecialty
9906MAMDClinical Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1315267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484265600000",
    "number": "1366723215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 NORWELL ST.",
            "city": "NORFOLK",
            "state": "MA",
            "postal_code": "02056",
            "telephone_number": "617-605-1715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 MAIN STREET SUITE 7",
            "city": "MEDFIELD",
            "state": "MA",
            "postal_code": "02052",
            "telephone_number": "508-242-9666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKI",
        "first_name": "MARISSA",
        "middle_name": "LEE",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-06",
        "last_updated": "2017-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "9906",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2017; 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.