Individual provider Active NPI

Ladan Nabavi, LMHC, CAGS, PSY.D

  • Mental Health Counselor
  • Lynn, MA
National Provider Identifier
1427170638
Registry record updated Jun 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
5353 Issued in MA
Practice address
95 Pleasant St
Lynn, MA 01901-1524
Phone
(781) 581-4400
NPI assigned
Apr 6, 2007
Last updated
Jun 30, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 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 5353 MA Primary

Addresses

Primary practice location

95 Pleasant St
Lynn, MA 01901-1524

Mailing address

19 Dewitt Rd
Stoneham, MA 02180-3204

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
I20240110002521 MA Practitioner - Mental Health Counselor 4981055373 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Eliot Community Human ServicesGroup PAC ID 2062488000, 82 clinicians

Practice addresses (Care Compare)

86 Baker Ave Ext
Suite 100
Concord, MA 01742-2132
Phone (978) 369-1113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5353MAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Eliot Community Human Services CurrentSince Jan 1, 2024 Accepting new patients
Eliot Community Human Services CurrentSince Jan 1, 2024 Accepting new patients

Locations

86 Baker Avenue Ext
Ste 100
Concord, MA 01742
Phone (978) 202-4156

125 Hartwell Ave
Lexington, MA 02421
Phone (781) 734-2060

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1427170638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 DEWITT RD",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "021803204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 PLEASANT ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011524",
            "telephone_number": "781-581-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NABAVI",
        "first_name": "LADAN",
        "credential": "LMHC, CAGS, PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "5353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynn, MA

Sources for this page

Verify at the official NPI Registry.