Active NPI
Jennifer Lynn Staples, LMHC
- Mental Health Counselor
- Boston, MA
National Provider Identifier
1699907378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 7568
- Practice address
- 1960 Washington St
Boston, MA 02118-3219 - Phone
- (617) 878-2464
- Fax
- (617) 830-8844
- NPI assigned
- Aug 14, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 097-0001311 | VT | |
| Mental Health Counselor | 101YM0800X | 7568 | MA | Primary |
Addresses
Primary practice location
1960 Washington St
Boston, MA 02118-3219
Mailing address
1960 Washington St
Boston, MA 02118-3219
Phone (617) 878-2464
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7568 | MA | MD | Mental Health Counselor |
| 097-0001311 | VT | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409011200000",
"number": "1699907378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1960 WASHINGTON ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021183219",
"telephone_number": "617-878-2464",
"fax_number": "617-830-8844"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1960 WASHINGTON ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021183219",
"telephone_number": "617-878-2464",
"fax_number": "617-830-8844"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAPLES",
"first_name": "JENNIFER",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-14",
"last_updated": "2014-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "VT",
"license": "097-0001311",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "7568",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.