Individual provider Active NPI

Kristen Birch

  • Mental Health Counselor
  • West Boylston, MA
National Provider Identifier
1447567839
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
10489 Issued in MA
Practice address
148 Worcester St
West Boylston, MA 01583-1751
Phone
(508) 835-1735
NPI assigned
Sep 7, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 10489 MA Primary
Counselor 101Y00000X
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

148 Worcester St
West Boylston, MA 01583-1751

Mailing address

148 Worcester St
West Boylston, MA 01583-1751
Phone (508) 835-1735

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
I20241014000058 MA Practitioner - Mental Health Counselor 5799217998 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10489MAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Behavioral Health, LLC Counselor CurrentSince Aug 12, 2024 Accepting new patients

Locations

148 Worcester St
West Boylston, MA 01583
Phone (508) 835-1735

Organizations & group practices 1

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": "1283817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1447567839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 WORCESTER ST",
            "city": "WEST BOYLSTON",
            "state": "MA",
            "postal_code": "015831751",
            "telephone_number": "508-835-1735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 WORCESTER ST",
            "city": "WEST BOYLSTON",
            "state": "MA",
            "postal_code": "015831751",
            "telephone_number": "508-835-1735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRCH",
        "first_name": "KRISTEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-07",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "10489",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Boylston, MA

Sources for this page

Verify at the official NPI Registry.