Individual provider Active NPI

Ellen McCarthy

  • Mental Health Counselor
  • Woburn, MA
National Provider Identifier
1609212356
Registry record updated Feb 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
120525 Issued in MA
Practice address
10 Tower Office Park Ste 406
Woburn, MA 01801-2120
Phone
(978) 790-0308
NPI assigned
May 21, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X 120525 MA Primary

Addresses

Primary practice location

10 Tower Office Park Ste 406
Woburn, MA 01801-2120

Mailing address

62 Linden St
Reading, MA 01867-2549
Phone (978) 790-0308

Other practice location 1

336 Baker Ave Ste 1
Concord, MA 01742-2107
Phone (787) 900-3089

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 29, 2024 through Mar 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
120525MAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1369094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614470400000",
    "number": "1609212356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 LINDEN ST",
            "city": "READING",
            "state": "MA",
            "postal_code": "018672549",
            "telephone_number": "978-790-0308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 TOWER OFFICE PARK STE 406",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018012120",
            "telephone_number": "978-790-0308"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "336 Baker Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "MA",
            "postal_code": "017422107",
            "country_code": "US",
            "telephone_number": "787-900-3089",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCARTHY",
        "first_name": "ELLEN",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-21",
        "last_updated": "2021-02-28",
        "certification_date": "2021-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "120525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

Verify at the official NPI Registry.