Imari Rochell Medeiros

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

125732 Issued in MA

Practice address

27 Central SQ # 1008
Bridgewater, MA 02324-2508

Phone

(508) 685-8751

Fax

(508) 463-9994

NPI assigned

Jul 29, 2016

Reactivated

Feb 3, 2022

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

Other names 1

• Imari Rochell Gonzalez Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Golden Psychotherapy, PLLC

  • Clinical Social Worker
  • Brockton, MA
  • NPI 1447176581
  NPD (past) Authorized official

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

{
    "created_epoch": "1469750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1558814129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 CENTRAL SQ # 1008",
            "city": "BRIDGEWATER",
            "state": "MA",
            "postal_code": "023242508",
            "telephone_number": "508-233-3327",
            "fax_number": "508-463-9994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 CENTRAL SQ # 1008",
            "city": "BRIDGEWATER",
            "state": "MA",
            "postal_code": "023242508",
            "telephone_number": "508-685-8751",
            "fax_number": "508-463-9994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDEIROS",
        "first_name": "IMARI",
        "middle_name": "ROCHELL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-29",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "deactivation_date": "2022-01-06",
        "reactivation_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "125732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IMARI",
            "last_name": "GONZALEZ",
            "middle_name": "ROCHELL",
            "credential": "LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Maria L. McHargue, LICSW
• Carol Y McLellan
• Nora McLellan, RN
• Erin McNamara
• MDM Creative Counseling Services LLC
• Jaime Meighan
• Peter David Mello, PT
• Memorable Moments Mass
• Melody Messer, P.T.A.
• Patrick Michel, PHARMD

• Mental Health Counselor in Bridgewater, MA
• Providers in Bridgewater, 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 Jul 27, 2026; 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.