Individual provider Active NPI

Sky Thomas, MT-BC

  • Addiction (Substance Use Disorder) Counselor
  • Boston, MA
National Provider Identifier
1538872304
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
23 Bradston St
Boston, MA 02118-2703
Phone
(617) 318-6480
Fax
(617) 427-1263
NPI assigned
Dec 27, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Music Therapist 225A00000X 17199 NJ
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

23 Bradston St
Boston, MA 02118-2703

Mailing address

23 Bradston St FL 1
Boston, MA 02118-2703
Phone (617) 318-6480

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tlicato@hcrcenters.com BayMark Health Services, Inc.

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

State licenses

LicenseStateTypeSpecialty
17199NJMDMusic Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
HCRC CurrentSince Jan 1, 2023 Accepting new patients
Community Physicians PC PastSince Mar 31, 2024 Accepting new patients
Community Health Care, Inc. Addiction (Substance Use Disorder) PastSince Jan 1, 2023 Accepting new patients

Locations

23 Bradston St
Boston, MA 02118
Phone (617) 318-6480

23 Bradston St
Fl 1
Boston, MA 02118
Phone (617) 271-2193

Organizations & group practices 3

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": "1672099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1538872304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 BRADSTON ST FL 1",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182703",
            "telephone_number": "617-318-6480",
            "fax_number": "617-427-1263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 BRADSTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182703",
            "telephone_number": "617-318-6480",
            "fax_number": "617-427-1263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "SKY",
        "credential": "MT-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-27",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225A00000X",
            "taxonomy_group": "",
            "desc": "Music Therapist",
            "state": "NJ",
            "license": "17199",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tlicato@hcrcenters.com",
            "affiliation": "Y",
            "endpointDescription": "Work Email",
            "affiliationName": "BayMark Health Services, Inc.",
            "address_1": "23 Bradston St",
            "city": "Boston",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021182703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; 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.