Individual provider Active NPI

Fortunate Munhutu, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Woburn, MA
National Provider Identifier
1750961561
Registry record updated Dec 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2307110 Issued in MA
Practice address
400 Tradecenter Ste 5900
Woburn, MA 01801-7471
Phone
(617) 468-1115
Fax
(844) 440-2345
NPI assigned
Apr 14, 2021
Last updated
Dec 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 113077-23 NH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2307110 MA Primary

Addresses

Primary practice location

400 Tradecenter Ste 5900
Woburn, MA 01801-7471

Mailing address

400 Tradecenter Ste 5900
Woburn, MA 01801-7471
Phone (617) 468-1115

Other practice location 1

15 Constitution Dr Ste 1A
Bedford, NH 03110-6002
Phone (617) 468-1115

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210928003054 MA Practitioner - Nurse Practitioner 5193001055 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

400 Tradecenter
Suite 5900
Woburn, MA 01801-7471
Phone (617) 468-1115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
113077-23NHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Healthlink, Inc. CurrentSince Oct 4, 2021 Accepting new patients
My Mental Health Matters Psychiatric Services LLC Psychiatric/Mental Health CurrentSince Nov 1, 2022 Accepting new patients
Community Healthlink Inc CurrentSince Oct 4, 2021 Accepting new patients
Among Friends Home Health, Inc. PastSince Mar 23, 2017 Accepting new patients

Locations

40 Spruce St
Leominster, MA 01453
Phone (978) 466-3820

40 Spruce St
#2
Leominster, MA 01453
Phone (978) 534-6116

400 Tradecenter
Ste 5900
Woburn, MA 01801
Phone (617) 468-1115

72 Jaques Ave
Worcester, MA 01610
Phone (508) 860-1154

Organizations & group practices 4

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": "1618358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1750961561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 TRADECENTER STE 5900",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018017471",
            "telephone_number": "617-468-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 TRADECENTER STE 5900",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018017471",
            "telephone_number": "617-468-1115",
            "fax_number": "844-440-2345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Constitution Dr Ste 1A",
            "address_purpose": "LOCATION",
            "city": "Bedford",
            "state": "NH",
            "postal_code": "031106002",
            "country_code": "US",
            "telephone_number": "617-468-1115",
            "fax_number": "844-440-2345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUNHUTU",
        "first_name": "FORTUNATE",
        "name_prefix": "Dr.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-14",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NH",
            "license": "113077-23",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2307110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

Verify at the official NPI Registry.