Kintsugi Collaborative Counseling

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

KINTSUGI COLLABORATIVE COUNSELING

Doing business as

Kintsugi Collaborative Counseling

Practice address

768 Turnpike St
Canton, MA 02021-2806

Phone

(617) 877-5351

NPI assigned

Apr 5, 2021

Last updated

Apr 5, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Yelena Lukashev, MA, LMHCNPI 1073923363

Title

Owner

Phone

(617) 877-5351

Specialties & licenses 1

Addresses

Other names 1

• Kintsugi Collaborative Counseling Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Yelena Z Lukashev, MA

  • Counselor
  • West Roxbury, MA
  • NPI 1073923363
  NPD Authorized official

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617580800000",
    "number": "1659950921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "768 TURNPIKE ST",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020212806",
            "telephone_number": "617-877-5351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "768 TURNPIKE ST",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020212806",
            "telephone_number": "617-877-5351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINTSUGI COLLABORATIVE COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-05",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A",
        "authorized_official_last_name": "LUKASHEV",
        "authorized_official_first_name": "YELENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-877-5351",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA, LMHC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kintsugi Collaborative Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Canton, MA
• Providers in Canton, MA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; 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.