Individual provider Active NPI

Western W Ivey, LMHC

  • Mental Health Counselor
  • Jamaica Plain, MA
National Provider Identifier
1679799381
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
31 Heath St
Jamaica Plain, MA 02130-1650
Phone
(617) 523-6400
Fax
(617) 622-1086
NPI assigned
Apr 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

31 Heath St
Jamaica Plain, MA 02130-1650

Mailing address

31 Heath St
Jamaica Plain, MA 02130-1650
Phone (617) 523-6400

Other identifiers 1

IdentifierTypeStateIssuer
1303414MedicaidMA

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
I20240313002523 MA Practitioner - Mental Health Counselor 6901242833 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
New England Center for Mental Health LLC Mental Health CurrentSince Jan 17, 2024 Accepting new patients
Family Service Association of Greater Boston Past Accepting new patients

Locations

289 Great Rd
Ste G1
Acton, MA 01720
Phone (978) 679-1200

Organizations & group practices 2

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": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1679799381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 HEATH ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021301650",
            "telephone_number": "617-523-6400",
            "fax_number": "617-622-1086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 HEATH ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021301650",
            "telephone_number": "617-523-6400",
            "fax_number": "617-622-1086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVEY",
        "first_name": "WESTERN",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1303414",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica Plain, MA

Sources for this page

Verify at the official NPI Registry.