Individual provider Active NPI

Charlene Flynn

  • Mental Health Counselor
  • Waltham, MA
National Provider Identifier
1457055980
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
13171 Issued in MA
Practice address
61 High St Apt 2
Waltham, MA 02453-0585
Phone
(774) 270-2012
NPI assigned
Mar 29, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 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 13171 MA Primary

Addresses

Primary practice location

61 High St Apt 2
Waltham, MA 02453-0585

Mailing address

61 High St Apt 2
Waltham, MA 02453-0585
Phone (774) 270-2012

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
I20240223001986 MA Practitioner - Mental Health Counselor 0749625234 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13171MAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Brookline Community Mental Health Center Inc. CurrentSince Feb 13, 2024 Accepting new patients
Compassionate Counseling Company CurrentSince Jan 1, 2026 Accepting new patients

Locations

43 Garrison Rd
Brookline, MA 02445
Phone (617) 277-8107

4 Hartwell St
Ste 201
Fall River, MA 02721
Phone (774) 218-5440

Organizations & group practices 2

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": "1680048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1457055980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 HIGH ST APT 2",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024530585",
            "telephone_number": "774-270-2012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 HIGH ST APT 2",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024530585",
            "telephone_number": "774-270-2012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLYNN",
        "first_name": "CHARLENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-29",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "13171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

Verify at the official NPI Registry.