Active NPI
Kevin Joseph Fenlon
- Mental Health Counselor
- Westborough, MA
National Provider Identifier
1699945667
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 6441
- Practice address
- 57 E Main St
Westborough, MA 01581-1464 - Phone
- (508) 366-0406
- NPI assigned
- Mar 6, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 6441 | MA | Primary |
Addresses
Primary practice location
57 E Main St
Westborough, MA 01581-1464
Mailing address
4 Sprucewood LN
Worcester, MA 01606-1193
Phone (508) 852-1851
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 |
|---|---|---|---|
| 6441 | MA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204761600000",
"number": "1699945667",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 SPRUCEWOOD LN",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016061193",
"telephone_number": "508-852-1851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "57 E MAIN ST",
"city": "WESTBOROUGH",
"state": "MA",
"postal_code": "015811464",
"telephone_number": "508-366-0406"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FENLON",
"first_name": "KEVIN",
"middle_name": "JOSEPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-03-06",
"last_updated": "2008-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "6441",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Westborough, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.