Active NPI
Paul A Goulet, LCSW
- Mental Health Counselor
- Quincy, MA
National Provider Identifier
1659512275
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 413252
- Practice address
- 500 Victory Rd
Quincy, MA 02171-3139 - Phone
- (617) 847-1926
- NPI assigned
- Mar 11, 2009
- Last updated
- Aug 4, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 413252 | MA | Primary |
| Mental Health Counselor | 101YM0800X | 217985 | MA |
Addresses
Primary practice location
500 Victory Rd
Quincy, MA 02171-3139
Mailing address
7 Green St
Marion, MA 02738-1126
Phone (508) 523-7654
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| M18708 | Other | MA | BLUE CROSS |
| 1312677 | Medicaid | MA | |
| 1004370 | Other | MA | NHP |
| 685661 | Other | MA | TUFTS |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230713003665 | MA | Practitioner - Clinical Social Worker | 7416317003 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 217985 | MA | MD | Mental Health Counselor |
| 413252 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470268800000",
"number": "1659512275",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 GREEN ST",
"city": "MARION",
"state": "MA",
"postal_code": "027381126",
"telephone_number": "508-523-7654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 VICTORY RD",
"city": "QUINCY",
"state": "MA",
"postal_code": "021713139",
"telephone_number": "617-847-1926"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOULET",
"first_name": "PAUL",
"middle_name": "A",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-03-11",
"last_updated": "2016-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "413252",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "217985",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "M18708",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1312677",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NHP",
"identifier": "1004370",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "685661",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Quincy, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.