Kevin C Ketchum, MS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

639 Granite St Ste 310
Braintree, MA 02184-5370

Phone

(617) 935-7748

NPI assigned

Apr 5, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Nova Psychiatric Services, P.CGroup PAC ID 4183524887, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

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.

• Nova Psychiatric Services, PC

  dba Prime Behavioral Health

  • Community/Behavioral Health Agency
  • Quincy, MA
  • NPI 1881782522
  Medicare reassignment Care Compare group NPD
• Sweeney Dawley Recovery Center, LLC.

  • Family Health Clinical Nurse Specialist
  • Braintree, MA
  • NPI 1730622325
  NPD

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

{
    "created_epoch": "1175731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1770605131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 NECK ST # UC5",
            "city": "NORTH WEYMOUTH",
            "state": "MA",
            "postal_code": "021911939",
            "telephone_number": "617-935-7748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 GRANITE ST STE 310",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021845370",
            "telephone_number": "617-935-7748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETCHUM",
        "first_name": "KEVIN",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-05",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Philippe Kelty, PH.D.
• Virginia A. Kelty, PH. D.
• Kennedy Brothers Physical Therapy Inc.
• Richard P Kennedy, PTSCS
• Colleen Keohane
• Mehnaz Khan, M.D.
• Kaitlyn Rose Kilban, M.S., CCC-SLP
• John C. Kimble, DMD
• King Optical Co Inc
• Linda Wolf King, PT

• Mental Health Counselor in Braintree, MA
• Providers in Braintree, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.