NPIMap

Individual provider Active NPI

Kailey Teresa Fasugba, LMHC

  • Mental Health Counselor
  • N Chelmsford, MA
National Provider Identifier
1437582947
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
73 Princeton St Ste 212
N Chelmsford, MA 01863-1681
Phone
(978) 710-7569
NPI assigned
Aug 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2023

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 Primary

Addresses

Primary practice location

73 Princeton St Ste 212
N Chelmsford, MA 01863-1681

Mailing address

73 Princeton St Ste 212
N Chelmsford, MA 01863-1681
Phone (978) 710-7569

Other practice location 1

12 Methuen St Fl 3
Lawrence, MA 01840-1700
Phone (978) 620-1702

Other names 1

  • Kailey Teresa Keiser Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hidden Gems Counseling LLC Current Accepting new patients
Therapy Associates of Chelmsford,LLC CurrentSince May 7, 2023 Accepting new patients
Northeast Behavioral Health Corporation PastSince May 8, 2017 Accepting new patients
C.R.E.a.T.E. Center for Expressive Arts,Therapy and Education,P.L.L.C. Mental Health Past Accepting new patients

Locations

6 Liberty Sq
Boston, MA 02109
Phone (423) 827-5300

73 Princeton St
Ste 212
North Chelmsford, MA 01863
Phone (978) 424-6789

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1376956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1437582947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 PRINCETON ST STE 212",
            "city": "N CHELMSFORD",
            "state": "MA",
            "postal_code": "018631681",
            "telephone_number": "978-710-7569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 PRINCETON ST STE 212",
            "city": "N CHELMSFORD",
            "state": "MA",
            "postal_code": "018631681",
            "telephone_number": "978-710-7569"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12 Methuen St Fl 3",
            "address_purpose": "LOCATION",
            "city": "Lawrence",
            "state": "MA",
            "postal_code": "018401700",
            "country_code": "US",
            "telephone_number": "978-620-1702",
            "fax_number": "978-682-7296",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FASUGBA",
        "first_name": "KAILEY",
        "middle_name": "TERESA",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-20",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAILEY",
            "last_name": "KEISER",
            "middle_name": "TERESA",
            "credential": "MA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in N Chelmsford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2023; 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.