Gladys Nakungu Kasansula

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

Square Medical Group
124 Watertown Street, Suite 2D
Watertown, MA 02472

Phone

(617) 916-5069

NPI assigned

Oct 9, 2018

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Square Medical Group LLC

  • Adult Mental Health Clinic/Center
  • Watertown, MA
  • NPI 1356515464
  NPD (past)
• Square Medical Group LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Watertown, MA
  • NPI 1760957609
  NPD (past)

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

{
    "created_epoch": "1539043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539043200000",
    "number": "1548735327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 WHITES AVE APT 27",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024724323",
            "telephone_number": "617-407-9385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SQUARE MEDICAL GROUP",
            "address_2": "124 WATERTOWN STREET, SUITE 2D",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "02472",
            "telephone_number": "617-916-5069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASANSULA",
        "first_name": "GLADYS",
        "middle_name": "NAKUNGU",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-09",
        "last_updated": "2018-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Manal Kachmar, PHD
• Madison Kadra
• David Phillip Kalter, M.S.
• Lauren Kamerzel, LMHC
• Casey Kane
• Amanda Kasper
• Paul L. Kasuba, MD
• Douglas Kaufman
• Sarah Kaye, N.P.
• William Michael Keane, PH.D,

• Mental Health Counselor in Watertown, MA
• Providers in Watertown, 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 Oct 9, 2018; 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.