Individual provider Active NPI

Kenna Lyn Ventura

  • Counselor
  • Fitchburg, MA
National Provider Identifier
1609366988
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
111 Columbia Ave
Fitchburg, MA 01420-7042
Phone
(508) 740-1440
NPI assigned
May 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

111 Columbia Ave
Fitchburg, MA 01420-7042

Mailing address

111 Columbia Ave
Fitchburg, MA 01420-7042

Other practice location 1

411 Chandler St
Worcester, MA 01602-3339
Phone (508) 799-0688

Other names 1

  • Kenna Lyn Tyrrell Former name

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
I20240216002898 MA Practitioner - Mental Health Counselor 2769826809 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Health Services LLCGroup PAC ID 6901866706, 470 clinicians
Hri Clinics, Inc.Group PAC ID 8022088483, 104 clinicians

Practice addresses (Care Compare)

108 Grove St
Suite 307 310
Worcester, MA 01605-2651
Phone (508) 206-8757

411 Chandler St
Worcester, MA 01602-3339
Phone (508) 799-0688

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hri Clinics Inc CurrentSince Jan 1, 2024 Accepting new patients
Hri Clinics, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Northeast Health Services, LLC CurrentSince Aug 1, 2025 Accepting new patients

Locations

14 Fordham Rd
Boston, MA 02134
Phone (617) 783-9676

30 Taunton Grn
Ste 5
Taunton, MA 02780
Phone (508) 545-7400

108 Grove St
Ste 307310
Worcester, MA 01605
Phone (508) 206-8757

411 Chandler St
Worcester, MA 01602
Phone (508) 471-5600

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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": "1526169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1609366988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 COLUMBIA AVE",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014207042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COLUMBIA AVE",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014207042",
            "telephone_number": "508-740-1440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "411 Chandler St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016023339",
            "country_code": "US",
            "telephone_number": "508-799-0688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VENTURA",
        "first_name": "KENNA",
        "middle_name": "LYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-13",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENNA",
            "last_name": "TYRRELL",
            "middle_name": "LYN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fitchburg, MA

Sources for this page

Verify at the official NPI Registry.