Individual provider Active NPI

Debra Sue Rooklin, LMHC

  • Mental Health Counselor
  • North Quincy, MA
National Provider Identifier
1730455296
Registry record updated Mar 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
730 Issued in MA
Practice address
2 Blackstone Park
North Quincy, MA 02171-0004
Phone
(617) 532-5554
Fax
(617) 532-5560
NPI assigned
Mar 29, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2012

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 730 MA Primary

Addresses

Primary practice location

2 Blackstone Park
North Quincy, MA 02171-0004

Mailing address

PO Box 240
North Quincy, MA 02171-0004
Phone (617) 532-5554

Other names 1

  • Miss Debra Sue Goldstein Former name

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
730MAMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
A Better State, LLC. Current Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1332979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332979200000",
    "number": "1730455296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 240",
            "city": "NORTH QUINCY",
            "state": "MA",
            "postal_code": "021710004",
            "telephone_number": "617-532-5554",
            "fax_number": "617-532-5560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 BLACKSTONE PARK",
            "city": "NORTH QUINCY",
            "state": "MA",
            "postal_code": "021710004",
            "telephone_number": "617-532-5554",
            "fax_number": "617-532-5560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOKLIN",
        "first_name": "DEBRA",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-29",
        "last_updated": "2012-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBRA",
            "last_name": "GOLDSTEIN",
            "middle_name": "SUE",
            "prefix": "MISS",
            "credential": "LMHC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in North Quincy, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2012; 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.