Janelle Marie Dextradeur, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

11568 Issued in MA

Practice address

80 Erdman Way
Suite 208
Leominster, MA 01453

Phone

(781) 353-8839

NPI assigned

Jun 19, 2017

Last updated

Feb 13, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Spectrum Health Systems, Inc

  • Community/Behavioral Health Agency
  • Worcester, MA
  • NPI 1346430253
  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  MA

  Medicare reassignment NPD
• Spectrum Health Systems Inc

  • Multi-Specialty Clinic/Center
  • Worcester, MA
  • NPI 1376827188
  NPD

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

{
    "created_epoch": "1497830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1447780721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 ERDMAN WAY STE 208",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014531840",
            "telephone_number": "781-353-8839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 ERDMAN WAY",
            "address_2": "SUITE 208",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "01453",
            "telephone_number": "781-353-8839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEXTRADEUR",
        "first_name": "JANELLE",
        "middle_name": "MARIE",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-19",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "11568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maryanne Therese Deprospo, BSN
• Dermatology Associates of Worcester County, P.C.
• Sarah Desilets
• Sheila Rita Despres, P.T.
• Praveen Devineni, M.D
• Chantal Louise Dibartolomeo
• Laura Dicienzo, LICSW
• Sebastiano Didato, M.D.
• Jennifer Dietz, PT
• Emilie Difficile

• Mental Health Counselor in Leominster, MA
• Providers in Leominster, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.