Individual provider Active NPI

Danielle M Providakes

  • Mental Health Counselor
  • Somerville, MA
National Provider Identifier
1699057737
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
9335 Issued in MA
Practice address
399 Revolution Dr
Somerville, MA 02145-1484
Phone
(800) 856-1983
NPI assigned
Sep 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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 9335 MA Primary

Addresses

Primary practice location

399 Revolution Dr
Somerville, MA 02145-1484

Mailing address

399 Revolution Dr
Somerville, MA 02145-1484

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
I20250708003511 MA Practitioner - Mental Health Counselor 0547774945 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9335MAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Community Physicians Inc CurrentSince Aug 27, 2025 Accepting new patients
Mass General Brigham Urgent Care LLC Current Accepting new patients
Mass General Brigham Community Physicians Inc. Mental Health CurrentSince Aug 27, 2025 Accepting new patients

Locations

500 Merrimack St
Lawrence, MA 01843
Phone (978) 557-8800

399 Revolution Dr
Somerville, MA 02145
Phone (800) 856-1983

399 Revolution Dr
Ste 1010
Somerville, MA 02145
Phone (857) 282-2063

Interoperability endpoints

  • Direct secure messaging: providakes.danielle.mgbcp@direct.partners.masshiway.net

Organizations & group practices 3

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": "1315958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1699057737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "399 REVOLUTION DR",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021451484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 REVOLUTION DR",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021451484",
            "telephone_number": "800-856-1983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVIDAKES",
        "first_name": "DANIELLE",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-14",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "9335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

Verify at the official NPI Registry.