Individual provider Active NPI

Katelyn Keleigh Macdonald, LMHC

  • Mental Health Counselor
  • Allston, MA
National Provider Identifier
1619512373
Registry record updated Nov 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
8962 Issued in MA
Practice address
250 Lincoln St
Allston, MA 02134-1318
Phone
(617) 553-5712
Fax
(617) 232-2165
NPI assigned
Nov 16, 2019
Last updated
Nov 16, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 8962 MA Primary

Addresses

Primary practice location

250 Lincoln St
Allston, MA 02134-1318

Mailing address

2 Cambridge Ter Apt 1
Cambridge, MA 02140-2669
Phone (603) 843-5108

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
8962MAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Andover Therapy Services LLC Mental Health CurrentSince Dec 18, 2022 Accepting new patients

Locations

38 Main St
Ste 2B
Andover, MA 01810
Phone (603) 843-5108

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1573862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573862400000",
    "number": "1619512373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CAMBRIDGE TER APT 1",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021402669",
            "telephone_number": "603-843-5108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 LINCOLN ST",
            "city": "ALLSTON",
            "state": "MA",
            "postal_code": "021341318",
            "telephone_number": "617-553-5712",
            "fax_number": "617-232-2165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDONALD",
        "first_name": "KATELYN",
        "middle_name": "KELEIGH",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-16",
        "last_updated": "2019-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "8962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allston, MA

Sources for this page

Verify at the official NPI Registry.