Organization Active NPI

Fahari Psychiatric and Mental Health Services

  • Psychiatric/Mental Health Nurse Practitioner
  • West Boylston, MA
National Provider Identifier
1457169633
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
FAHARI PSYCHIATRIC AND MENTAL HEALTH SERVICES
Practice address
352 W Boylston St Ste 233
West Boylston, MA 01583-2342
Phone
(774) 623-1241
NPI assigned
Dec 20, 2024
Last updated
Mar 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Authorized official

Name
Dr. Marygoretti Wairimu Kibe, DNPNPI 1780049734
Title
Pmhnp-BC
Phone
(774) 623-1241

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Psychiatric/Mental Health Nurse Practitioner 363LP0808X Primary

Addresses

Primary practice location

352 W Boylston St Ste 233
West Boylston, MA 01583-2342

Mailing address

352 W Boylston St Ste 233
West Boylston, MA 01583-2342
Phone (774) 623-1241

Other names 1

  • None Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250320000767 MA Part B Supplier - Clinic/Group Practice 9234651100 Receives reassigned benefits from 1 practitioner
Practice locations: West Boylston, MA

National Provider Directory

National Provider Directory

Locations

352 W Boylston St
Ste 233
West Boylston, MA 01583
Phone (774) 623-1241

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1734652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742428800000",
    "number": "1457169633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "352 W BOYLSTON ST STE 233",
            "city": "WEST BOYLSTON",
            "state": "MA",
            "postal_code": "015832342",
            "telephone_number": "774-623-1241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "352 W BOYLSTON ST STE 233",
            "city": "WEST BOYLSTON",
            "state": "MA",
            "postal_code": "015832342",
            "telephone_number": "774-623-1241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAHARI PSYCHIATRIC AND MENTAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-20",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A",
        "authorized_official_last_name": "KIBE",
        "authorized_official_first_name": "MARYGORETTI",
        "authorized_official_middle_name": "WAIRIMU",
        "authorized_official_title_or_position": "PMHNP-BC",
        "authorized_official_telephone_number": "774-623-1241",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "None",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "None",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in West Boylston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.