Active NPI
Christine L Bavaro, MED LMHC
- Mental Health Counselor
- Lynnfield, MA
National Provider Identifier
1609824820
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 3855
- Practice address
- 7 Kimball LN
Lynnfield, MA 01940-2617 - Phone
- (781) 246-2315
- NPI assigned
- May 4, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 3855 | MA | Primary |
| Social Worker | 104100000X | 200200 | MA |
Addresses
Primary practice location
7 Kimball LN
Lynnfield, MA 01940-2617
Mailing address
55-14 Ash St
Danvers, MA 01923
Phone (978) 774-7975
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 142082XX | Other | NY | PREFERRED CARE |
| 3855 | Other | LMHC | |
| 200200 | Other | LCSW | |
| ROLM0015 | Other | MA | BCBS |
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 Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200200 | MA | MD | Social Worker |
| 3855 | MA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491782400000",
"number": "1609824820",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55-14 ASH ST",
"city": "DANVERS",
"state": "MA",
"postal_code": "01923",
"telephone_number": "978-774-7975",
"fax_number": "978-774-3360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 KIMBALL LN",
"city": "LYNNFIELD",
"state": "MA",
"postal_code": "019402617",
"telephone_number": "781-246-2315"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAVARO",
"first_name": "CHRISTINE",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "MED LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-04",
"last_updated": "2017-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "3855",
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MA",
"license": "200200",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED CARE",
"identifier": "142082XX",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LMHC",
"identifier": "3855",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCSW",
"identifier": "200200",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "ROLM0015",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lynnfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.