Individual provider Active NPI

Heather L. Audette, LMHC

  • Mental Health Counselor
  • Boston, MA
National Provider Identifier
1396076592
Registry record updated Jan 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
867 Boylston St.
5TH Floor #1166
Boston, MA 02116-2774
Phone
(781) 214-1858
NPI assigned
Jan 27, 2010
Reactivated
May 18, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2023

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

867 Boylston St.
5TH Floor #1166
Boston, MA 02116-2774

Mailing address

867 Boylston St.
5TH Floor #1166
Boston, MA 02116-2774
Phone (781) 214-1858

Other identifiers 1

IdentifierTypeStateIssuer
1225745540OtherMANPI2

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
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jul 24, 2024 through Jul 24, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ivy Path Counseling PLLC Mental Health Current Accepting new patients

Locations

867 Boylston St
Fl 5
Boston, MA 02116
Phone (617) 221-3202

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": "1264550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1396076592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "867 BOYLSTON ST.",
            "address_2": "5TH FLOOR #1166",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021162774",
            "telephone_number": "781-214-1858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "867 BOYLSTON ST.",
            "address_2": "5TH FLOOR #1166",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021162774",
            "telephone_number": "781-214-1858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUDETTE",
        "first_name": "HEATHER",
        "middle_name": "L.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-27",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "deactivation_date": "2011-07-14",
        "reactivation_date": "2015-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI2",
            "identifier": "1225745540",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.