Individual provider Active NPI

Sawsan Shabazz-Colon

  • Counselor
  • Canton, MA
National Provider Identifier
1750777108
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
345 Neponset St Ste 1
Canton, MA 02021-1988
Phone
(774) 321-3913
NPI assigned
Apr 13, 2015
Reactivated
Jun 6, 2022
Last updated
Oct 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU Primary

Addresses

Primary practice location

345 Neponset St Ste 1
Canton, MA 02021-1988

Mailing address

345 Neponset St Ste 1
Canton, MA 02021-1988
Phone (781) 633-7751

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
I20240905003792 MA Practitioner - Mental Health Counselor 0547700429 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA CurrentSince Jul 30, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

100 Cambridge St
Fl 14
Boston, MA 02114
Phone (617) 917-2389

Interoperability endpoints

  • Direct secure messaging: sshabazzcolon38923@direct.chppoc.masshiway.net

Organizations & group practices 2

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": "1428883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1750777108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 NEPONSET ST STE 1",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020211988",
            "telephone_number": "781-633-7751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 NEPONSET ST STE 1",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020211988",
            "telephone_number": "774-321-3913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHABAZZ-COLON",
        "first_name": "SAWSAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-13",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "deactivation_date": "2022-03-23",
        "reactivation_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MA

Sources for this page

Verify at the official NPI Registry.