Active NPI
Jonathan Blaisdell, M.A.
- Mental Health Counselor
- Norwell, MA
National Provider Identifier
1609292192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 10709
- Practice address
- 40 Accord Park Dr Ste A110
Norwell, MA 02061-1613 - Phone
- (781) 435-7941
- NPI assigned
- Mar 9, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 10709 | MA | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 10709 | MA | |
| Professional Counselor | 101YP2500X | 10709 | MA | |
| Mental Health Counselor | 101YM0800X | 10709 | MA | Primary |
Addresses
Primary practice location
40 Accord Park Dr Ste A110
Norwell, MA 02061-1613
Mailing address
40 Accord Park Dr Ste A110
Norwell, MA 02061-1613
Phone (781) 435-7941
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Father 2 Father, Inc. | Counselor | Current | Accepting new patients |
| Mill Pond Counseling LLC | Counselor | Current | Accepting new patients |
Locations
40 Accord Park Dr
Ste A110
Norwell, MA 02061
Phone (781) 435-7941
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": "1394323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662508800000",
"number": "1609292192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 ACCORD PARK DR STE A110",
"city": "NORWELL",
"state": "MA",
"postal_code": "020611613",
"telephone_number": "781-435-7941"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 ACCORD PARK DR STE A110",
"city": "NORWELL",
"state": "MA",
"postal_code": "020611613",
"telephone_number": "781-435-7941"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAISDELL",
"first_name": "JONATHAN",
"name_prefix": "Mr.",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-03-09",
"last_updated": "2022-09-07",
"certification_date": "2021-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MA",
"license": "10709",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MA",
"license": "10709",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MA",
"license": "10709",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "10709",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norwell, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.