Individual provider Active NPI

Hazell Imbert, LMHC

  • Mental Health Counselor
  • Boston, MA
National Provider Identifier
1578286183
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
009999 Issued in NY
Practice address
75 State St Ste 100
Boston, MA 02109-1826
Phone
(617) 380-3806
NPI assigned
Sep 20, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 009999 NY Primary

Addresses

Primary practice location

75 State St Ste 100
Boston, MA 02109-1826

Mailing address

203 Washington St # 129
Salem, MA 01970-3607
Phone (617) 380-3806

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240118003989 MA Practitioner - Mental Health Counselor 4183076755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Behavioral Health CorporationGroup PAC ID 0446155808, 42 clinicians

Practice addresses (Care Compare)

800 Cummings Ctr
Suite 266T
Beverly, MA 01915-6172
Phone (978) 921-1190

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009999NYMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Eliot Community Human Services CurrentSince Jan 1, 2024 Accepting new patients
Eliot Community Human Services Current Accepting new patients

Locations

75 Sylvan St
Danvers, MA 01923
Phone (978) 212-1010

125 Hartwell Ave
Lexington, MA 02421
Phone (781) 734-2060

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": "1663632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1578286183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 WASHINGTON ST # 129",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019703607",
            "telephone_number": "617-380-3806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 STATE ST STE 100",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021091826",
            "telephone_number": "617-380-3806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMBERT",
        "first_name": "HAZELL",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-20",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "009999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.