NPIMap

Organization Active NPI

Realized Performance, Inc.

  • Mental Health Counselor
  • Beverly, MA
National Provider Identifier
1659815819
Registry record updated Dec 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6791 Issued in MA
Legal business name
REALIZED PERFORMANCE, INC.
Practice address
234 Cabot St
Suite 3
Beverly, MA 01915-5723
Phone
(978) 408-9962
Fax
(978) 969-3407
NPI assigned
Dec 7, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2016

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

Authorized official

Name
Noah Erikson, LMHC
Title
Owner
Phone
(978) 408-9962

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 6791 MA Primary

Addresses

Primary practice location

234 Cabot St
Suite 3
Beverly, MA 01915-5723

Mailing address

234 Cabot St
Suite 3
Beverly, MA 01915-5723
Phone (978) 408-9962

National Provider Directory

National Provider Directory

Locations

234 Cabot St
Ste 3
Beverly, MA 01915
Phone (978) 408-9962

NPI Registry JSON

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

{
    "created_epoch": "1481068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481068800000",
    "number": "1659815819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 CABOT ST",
            "address_2": "SUITE 3",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019155723",
            "telephone_number": "978-408-9962",
            "fax_number": "978-969-3407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 CABOT ST",
            "address_2": "SUITE 3",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019155723",
            "telephone_number": "978-408-9962",
            "fax_number": "978-969-3407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REALIZED PERFORMANCE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-07",
        "last_updated": "2016-12-07",
        "status": "A",
        "authorized_official_last_name": "ERIKSON",
        "authorized_official_first_name": "NOAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "978-408-9962",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "6791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.