NPIMap

Organization Active NPI

South Shore Wellness & Renewal Inc.

  • Mental Health Counselor
  • Weymouth, MA
National Provider Identifier
1427487453
Registry record updated Apr 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
SOUTH SHORE WELLNESS & RENEWAL INC.
Practice address
851 Main St
Suite 16
Weymouth, MA 02190-1612
Phone
(781) 812-2701
Fax
(781) 803-2712
NPI assigned
Nov 12, 2013
Last updated
Apr 8, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2014

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

Authorized official

Name
Mr. Jason D Smith
Title
Ceo
Phone
(781) 812-2701

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Mental Health Counselor 101YM0800X NU Primary
Psychologist 103T00000X NU
Addiction (Substance Use Disorder) Psychologist 103TA0400X NU
Social Worker 104100000X NU
Marriage & Family Therapist 106H00000X NU

Addresses

Primary practice location

851 Main St
Suite 16
Weymouth, MA 02190-1612

Mailing address

851 Main St
Suite 16
Weymouth, MA 02190-1612
Phone (781) 812-2701

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1384214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396915200000",
    "number": "1427487453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 MAIN ST",
            "address_2": "SUITE 16",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021901612",
            "telephone_number": "781-812-2701",
            "fax_number": "857-202-5206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 MAIN ST",
            "address_2": "SUITE 16",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021901612",
            "telephone_number": "781-812-2701",
            "fax_number": "781-803-2712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SHORE WELLNESS & RENEWAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-12",
        "last_updated": "2014-04-08",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "781-812-2701",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weymouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.