Individual provider Active NPI

Courtney Joyce Flagg

  • Mental Health Counselor
  • Worcester, MA
National Provider Identifier
1578991402
Registry record updated Nov 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
340 Main St
Suite 818
Worcester, MA 01608-1604
Phone
(508) 791-6723
NPI assigned
Nov 1, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2013

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 Primary

Addresses

Primary practice location

340 Main St
Suite 818
Worcester, MA 01608-1604

Mailing address

330 Sunderland Rd
Unit #12
Worcester, MA 01604-2544
Phone (774) 823-0242

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
I20240319002255 MA Practitioner - Mental Health Counselor 0143667782 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
SB Transitional Sub, LLC CurrentSince Jan 16, 2024 Accepting new patients
South Bay Mental Health Center, Inc. PastSince Jun 27, 2018 Accepting new patients

Locations

1115 W Chestnut St
Brockton, MA 02301
Phone (508) 559-0473

103 Commercial St
Ste 2
Brockton, MA 02302

324 Clark St
Worcester, MA 01606
Phone (508) 752-3969

Organizations & group practices 2

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": "1383264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383264000000",
    "number": "1578991402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SUNDERLAND RD",
            "address_2": "UNIT #12",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016042544",
            "telephone_number": "774-823-0242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 MAIN ST",
            "address_2": "SUITE 818",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081604",
            "telephone_number": "508-791-6723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLAGG",
        "first_name": "COURTNEY",
        "middle_name": "JOYCE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-01",
        "last_updated": "2013-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.