Individual provider Active NPI

Russell P Mackay

  • Mental Health Counselor
  • Boston, MA
National Provider Identifier
1790877090
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LMHC10002806 Issued in MA
Practice address
434 Massachusetts Ave Ste 501
Boston, MA 02118-3522
Phone
(339) 666-8516
Fax
(617) 807-0958
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LMHC10002806 MA Primary
Mental Health Counselor 101YM0800X 5935490-6009 UT

Addresses

Primary practice location

434 Massachusetts Ave Ste 501
Boston, MA 02118-3522

Mailing address

1003 Eastgate Dr
Provo, UT 84606-5601
Phone (801) 380-3914

Other practice location 1

1003 Eastgate Dr
Provo, UT 84606-5601
Phone (801) 380-3914

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
I20250725001882 MA Practitioner - Mental Health Counselor 9638686694 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

434 Massachusetts Ave
Suite 501
Boston, MA 02118-3522
Phone (855) 284-7483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5935490-6009UTMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC Mental Health CurrentSince Apr 20, 2025 Accepting new patients
Utah Center for Psychological Services Past Accepting new patients

Locations

434 Massachusetts Ave
Ste 501
Boston, MA 02118

872 Massachusetts Ave
Ste 2-2
Cambridge, MA 02139
Phone 6173804651 ext. 1992

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1790877090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 EASTGATE DR",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846065601",
            "telephone_number": "801-380-3914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "434 MASSACHUSETTS AVE STE 501",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021183522",
            "telephone_number": "339-666-8516",
            "fax_number": "617-807-0958"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1003 Eastgate Dr",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846065601",
            "country_code": "US",
            "telephone_number": "801-380-3914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACKAY",
        "first_name": "RUSSELL",
        "middle_name": "P",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "LMHC10002806",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "5935490-6009",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.