Marie Berthonia Antoine, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1424 Blue Hill Ave
Mattapan, MA 02126-2277

Phone

(617) 828-7447

Fax

(617) 296-5552

NPI assigned

Jan 16, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1407907462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1424 BLUE HILL AVE",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021262277",
            "telephone_number": "617-828-7447",
            "fax_number": "617-296-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 BLUE HILL AVE",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021262277",
            "telephone_number": "617-828-7447",
            "fax_number": "617-296-5552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "745 River St",
            "address_purpose": "LOCATION",
            "city": "Mattapan",
            "state": "MA",
            "postal_code": "021261941",
            "country_code": "US",
            "telephone_number": "617-364-3035",
            "fax_number": "617-364-3059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANTOINE",
        "first_name": "MARIE",
        "middle_name": "BERTHONIA",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Mattapan, MA
• Providers in Mattapan, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; 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.

Verify at the official NPI Registry.