Gracie Vanessa Alleyne-Popo
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Quincy, MA
NPI 1780145409 · NPPES record last updated Mar 26, 2019
Key facts
- NPI
- 1780145409
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- Practice address
- 1419 Hancock St Ste 300
Quincy, MA 02169-5250 - Phone
- (617) 328-0639
- NPI assigned
- Mar 26, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240307001356 | CT | Practitioner - Mental Health Counselor | 6103262670 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1545 | CT | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Natchaug Hospital, Inc. | Current |
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Yes |
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
Other providers in Quincy, MA
- All Is Well LLC
- Allen Lapey MD Proprietorship
- Brandy A. Allen
- Jessica Allen
- Vicki Kathryn Allen
- Alliance Dental Center, LLC
- Alliance Health of Quincy, Inc.
- Alliance Health of Quincy, Inc.
- Allied Health Clinic LLC
- Allied Health Inc
All providers in Quincy, MA · Addiction (Substance Use Disorder) Counselor in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 26, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.