Individual provider Active NPI

Myungwoo Lee

  • Mental Health Counselor
  • Haverhill, MA
National Provider Identifier
1366967341
Registry record updated Jun 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
100 Plaistow Rd
Haverhill, MA 01830-1443
Phone
(978) 373-4985
NPI assigned
Aug 10, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2022

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

100 Plaistow Rd
Haverhill, MA 01830-1443

Mailing address

37 Harrington St
Revere, MA 02151-3907
Phone (603) 845-9909

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
I20240226003025 MA Practitioner - Mental Health Counselor 1951746320 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Systems, Inc CurrentSince Jan 1, 2024 Accepting new patients
Spectrum Health Systems Inc CurrentSince Jan 1, 2024 Accepting new patients
Spectrum Health Systems, Inc PastSince Jun 12, 2022 Accepting new patients
Bay State Community Services, Inc. PastSince Oct 1, 2020 Accepting new patients
South Bay Mental Health Center, Inc. PastSince Sep 27, 2019 Accepting new patients

Locations

100 Plaistow Rd
Ste B
Haverhill, MA 01830
Phone (978) 373-4985

149 Oak St
Westborough, MA 01581

585 Lincoln St
Worcester, MA 01605
Phone (508) 831-0045

10 Mechanic St
Ste 302
Worcester, MA 01608
Phone (508) 792-5400

Organizations & group practices 5

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": "1502323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1366967341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 HARRINGTON ST",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021513907",
            "telephone_number": "603-845-9909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PLAISTOW RD",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018301443",
            "telephone_number": "978-373-4985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "MYUNGWOO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-10",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Haverhill, MA

Sources for this page

Verify at the official NPI Registry.