Kathryn Elizabeth Fackina, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

210 Old Colony Ave
South Boston, MA 02127-2413

Phone

(617) 268-5000

NPI assigned

Dec 4, 2017

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

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.

Specialty

Mental Health Counselor

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

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.

• Gavin Foundation

  • Clinic/Center
  • South Boston, MA
  • NPI 1396079414
  NPD (past)

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

{
    "created_epoch": "1512345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512345600000",
    "number": "1417462169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 OLD COLONY AVE",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "021272413",
            "telephone_number": "617-268-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 OLD COLONY AVE",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "021272413",
            "telephone_number": "617-268-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FACKINA",
        "first_name": "KATHRYN",
        "middle_name": "ELIZABETH",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-04",
        "last_updated": "2017-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward W. Brooke 2 Charter School
• Steven Thomas Eggleston, PHARMD
• Amanda Enterante, CCC-SLP
• Andrea M Ericksen
• Fabienne Errie, MHA
• Thomas A. Fagan, DC
• Michelle P Farmer, LADC1
• Taline Farra, O.D.
• Joellyn Lee Ferro, D.M.D.
• Ari Fierer

• Mental Health Counselor in South Boston, MA
• Providers in South Boston, 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 Dec 4, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.