Active NPI
Nicole Tippets Forester
- Professional Counselor
- Malden, MA
National Provider Identifier
1366768418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 7063
- Practice address
- 6 Pleasant St
6TH Floor
Malden, MA 02148-5100 - Phone
- (781) 322-1503
- NPI assigned
- Apr 14, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 7063 | MA | Primary |
Addresses
Primary practice location
6 Pleasant St
6TH Floor
Malden, MA 02148-5100
Mailing address
108 Jersey St
12A
Boston, MA 02215-4836
Phone (801) 557-9912
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7063 | MA | MD | Psychologist |
Interoperability endpoints
- nicole.forester.1@30520.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271203200000",
"number": "1366768418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "108 JERSEY ST",
"address_2": "12A",
"city": "BOSTON",
"state": "MA",
"postal_code": "022154836",
"telephone_number": "801-557-9912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 PLEASANT ST",
"address_2": "6TH FLOOR",
"city": "MALDEN",
"state": "MA",
"postal_code": "021485100",
"telephone_number": "781-322-1503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORESTER",
"first_name": "NICOLE",
"middle_name": "TIPPETS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-04-14",
"last_updated": "2010-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MA",
"license": "7063",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Malden, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.