Individual provider Active NPI

Gracie Vanessa Alleyne-Popo

  • Addiction (Substance Use Disorder) Counselor
  • Quincy, MA
National Provider Identifier
1780145409
Registry record updated Mar 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
1419 Hancock St Ste 300
Quincy, MA 02169-5250
Phone
(617) 328-0639
NPI assigned
Mar 26, 2019
Last updated
Mar 26, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

1419 Hancock St Ste 300
Quincy, MA 02169-5250

Mailing address

66 Greenleaf St Apt 21
Quincy, MA 02169-4448
Phone (617) 373-0654

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20240307001356 CT Practitioner - Mental Health Counselor 6103262670 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1545CTMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Natchaug Hospital, Inc. CurrentSince Mar 1, 2024 Accepting new patients

Locations

189 Storrs Rd
Mansfield Ctr, CT 06250
Phone (860) 456-1311

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

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": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553558400000",
    "number": "1780145409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 GREENLEAF ST APT 21",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021694448",
            "telephone_number": "617-373-0654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1419 HANCOCK ST STE 300",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021695250",
            "telephone_number": "617-328-0639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEYNE-POPO",
        "first_name": "GRACIE",
        "middle_name": "VANESSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-26",
        "last_updated": "2019-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.