Individual provider Active NPI

Matthew Jonathan Iannolino I

  • Mental Health Counselor
  • Springfield, MA
National Provider Identifier
1386152627
Registry record updated Jan 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1695 Main St FL 400
Springfield, MA 01103-1063
Phone
(413) 739-5572
NPI assigned
Jan 22, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2018

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

1695 Main St FL 400
Springfield, MA 01103-1063

Mailing address

1695 Main St FL 400
Springfield, MA 01103-1063
Phone (413) 739-5572

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
I20221117002828 MA Practitioner - Clinical Social Worker 0648648980 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Boston Neurobehavioral Associates, LLCGroup PAC ID 9436142429, 159 clinicians

Practice addresses (Care Compare)

226 Field St
New Bedford, MA 02740-2133
Phone (508) 979-5557

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Neurobehavioral Associates, LLC CurrentSince Oct 1, 2022 Accepting new patients
Community Services Institute, Inc. PastSince Mar 11, 2012 Accepting new patients

Locations

226 Field St
New Bedford, MA 02740
Phone (508) 817-5129

Organizations & group practices 2

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": "1516579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516579200000",
    "number": "1386152627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1695 MAIN ST FL 400",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011031063",
            "telephone_number": "413-739-5572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1695 MAIN ST FL 400",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011031063",
            "telephone_number": "413-739-5572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IANNOLINO",
        "first_name": "MATTHEW",
        "middle_name": "JONATHAN",
        "name_suffix": "I",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-22",
        "last_updated": "2018-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.