Individual provider Active NPI

Tatjana Gorohovsky

  • Mental Health Counselor
  • Bedford, MA
National Provider Identifier
1710431606
Registry record updated Oct 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
205 Burlington Rd
Bedford, MA 01730
Phone
(781) 761-5089
Fax
(781) 275-7207
NPI assigned
Aug 8, 2016
Last updated
Oct 21, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary
Developmental Therapist 222Q00000X S71093474 MA

Addresses

Primary practice location

205 Burlington Rd
Bedford, MA 01730

Mailing address

205 Burlington Rd
Bedford, MA 01730-1406
Phone (781) 761-5089

Other practice location 1

321 Fortune Blvd
Milford, MA 01757-1750
Phone (508) 478-0207

Other practice location 2

321 Fortune Blvd
Milford, MA 01757-1750
Phone (508) 478-0207

Other identifiers 7

IdentifierTypeStateIssuer
M18633OtherMABCBS
0000023532OtherMABMC
99618201OtherMANETWORK HEALTH
1303287OtherMAMBHP
1004745OtherMAFALLON
042611055OtherMATAX ID
1004745OtherMANHP

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

LicenseStateTypeSpecialty
S71093474MAMDDevelopmental Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Edinburg Center Inc CurrentSince Oct 27, 2019 Accepting new patients

Locations

205 Burlington Rd
Bedford, MA 01730
Phone (781) 761-5064

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1470614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571616000000",
    "number": "1710431606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 BURLINGTON RD",
            "city": "BEDFORD",
            "state": "MA",
            "postal_code": "017301406",
            "telephone_number": "781-761-5089",
            "fax_number": "781-275-7207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 BURLINGTON RD",
            "city": "BEDFORD",
            "state": "MA",
            "postal_code": "01730",
            "telephone_number": "781-761-5089",
            "fax_number": "781-275-7207"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "321 Fortune Blvd",
            "address_purpose": "LOCATION",
            "city": "Milford",
            "state": "MA",
            "postal_code": "017571750",
            "country_code": "US",
            "telephone_number": "508-478-0207",
            "fax_number": "508-634-6984",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "321 Fortune Blvd",
            "address_purpose": "LOCATION",
            "city": "Milford",
            "state": "MA",
            "postal_code": "017571750",
            "country_code": "US",
            "telephone_number": "508-478-0207",
            "fax_number": "508-634-6984",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOROHOVSKY",
        "first_name": "TATJANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-08",
        "last_updated": "2019-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "MA",
            "license": "S71093474",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "M18633",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BMC",
            "identifier": "0000023532",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK HEALTH",
            "identifier": "99618201",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MBHP",
            "identifier": "1303287",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON",
            "identifier": "1004745",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "042611055",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHP",
            "identifier": "1004745",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.