Individual provider Active NPI

Thomas Connolly, LMHC

  • Addiction (Substance Use Disorder) Counselor
  • Hyannis, MA
National Provider Identifier
1619418761
Registry record updated Feb 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
9694 Issued in MA
Practice address
76 W Main St Ste 202
Hyannis, MA 02601-3752
Phone
(203) 434-3495
NPI assigned
Mar 9, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 9694 MA
Mental Health Counselor 101YM0800X 9694 MA
Addiction (Substance Use Disorder) Counselor 101YA0400X 9694 MA Primary

Addresses

Primary practice location

76 W Main St Ste 202
Hyannis, MA 02601-3752

Mailing address

76 W Main St Ste 202
Hyannis, MA 02601-3752
Phone (203) 434-3495

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
I20240528000145 MA Practitioner - Mental Health Counselor 6901248699 Practice locations: Yarmouth Port, MA

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

915 W Yarmouth Rd
Yarmouth Port, MA 02675-1949
Phone (203) 434-3495

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9694MAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1489017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550793600000",
    "number": "1619418761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 W MAIN ST STE 202",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026013752",
            "telephone_number": "203-434-3495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 W MAIN ST STE 202",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026013752",
            "telephone_number": "203-434-3495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "THOMAS",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-09",
        "last_updated": "2019-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MA",
            "license": "9694",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "9694",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "9694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyannis, MA

Sources for this page

Verify at the official NPI Registry.