Individual provider Active NPI

Paula Marie Duvelson-Chrysostome, PH.D., LMHC

  • Mental Health Counselor
  • Randolph, MA
National Provider Identifier
1437374477
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
4855 Issued in MA
Practice address
324 N Main St
Suites 3B & 8
Randolph, MA 02368-4170
Phone
(781) 986-4800
Fax
(781) 986-4801
NPI assigned
Apr 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 4855 MA Primary

Addresses

Primary practice location

324 N Main St
Suites 3B & 8
Randolph, MA 02368-4170

Mailing address

324 N Main St
Suites 3B & 8
Randolph, MA 02368-4170
Phone (781) 413-5923

Other identifiers 1

IdentifierTypeStateIssuer
1894641MedicaidMA

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
I20260107000560 MA Practitioner - Mental Health Counselor 2466948732 Practice locations: Stoughton, MA

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1996
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

38 Smith Ave
Stoughton, MA 02072-3937
Phone (781) 413-5984

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
4855MAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1437374477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 N MAIN ST",
            "address_2": "SUITES 3B & 8",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023684170",
            "telephone_number": "781-413-5923",
            "fax_number": "781-986-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 N MAIN ST",
            "address_2": "SUITES 3B & 8",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023684170",
            "telephone_number": "781-986-4800",
            "fax_number": "781-986-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUVELSON-CHRYSOSTOME",
        "first_name": "PAULA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PH.D., LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "4855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1894641",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Randolph, MA

Sources for this page

Verify at the official NPI Registry.