Active NPI
Sky Thomas, MT-BC
- Addiction (Substance Use Disorder) Counselor
- Boston, MA
National Provider Identifier
1538872304
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 17199 | NJ | MD | Music Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| HCRC | Current | Accepting new patients | |
| Community Physicians PC | Past | Accepting new patients | |
| Community Health Care, Inc. | Addiction (Substance Use Disorder) | Past | 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.
-
- Substance Abuse Rehabilitation Facility
- Boston, MA
- NPI 1689254898
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Westfield, MA
- NPI 1912980251
Addiction (Substance Use Disorder)
-
- Methadone Clinic
- Portland, ME
- NPI 1316242209
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.