Individual provider Active NPI

Sean Patrico, MA PSYCHOLOGY

  • Mental Health Counselor
  • Roslindale, MA
National Provider Identifier
1669874574
Registry record updated Sep 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
780 American Legion Hwy
Roslindale, MA 02131-3908
Phone
(617) 469-8500
Fax
(617) 469-8595
NPI assigned
Sep 23, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2014

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 Primary

Addresses

Primary practice location

780 American Legion Hwy
Roslindale, MA 02131-3908

Mailing address

780 American Legion Hwy
Roslindale, MA 02131-3908
Phone (617) 469-8500

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
I20181217001077 MA Practitioner - Clinical Psychologist 7618212812 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychology Associates IncGroup PAC ID 8628171501, 10 clinicians

Practice addresses (Care Compare)

323 Court St
Plymouth, MA 02360-4322
Phone (508) 747-2718

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
10861MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Psychology Associates Inc. CurrentSince Nov 1, 2018 Accepting new patients

Locations

323 Court St
Plymouth, MA 02360
Phone (508) 747-2705

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/psych-associate

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1411430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411430400000",
    "number": "1669874574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 AMERICAN LEGION HWY",
            "city": "ROSLINDALE",
            "state": "MA",
            "postal_code": "021313908",
            "telephone_number": "617-469-8500",
            "fax_number": "617-469-8595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 AMERICAN LEGION HWY",
            "city": "ROSLINDALE",
            "state": "MA",
            "postal_code": "021313908",
            "telephone_number": "617-469-8500",
            "fax_number": "617-469-8595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICO",
        "first_name": "SEAN",
        "credential": "MA PSYCHOLOGY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-23",
        "last_updated": "2014-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslindale, MA

Sources for this page

Verify at the official NPI Registry.