Individual provider Active NPI

Jody Lynn Tata, LMHC

  • Mental Health Counselor
  • Westminster, MA
National Provider Identifier
1811065824
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
4473 Issued in MA
Practice address
16 Wyman Rd
Westminster, MA 01473-1601
Phone
(978) 874-6427
Fax
(978) 874-7457
NPI assigned
Nov 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 4473 MA Primary

Addresses

Primary practice location

16 Wyman Rd
Westminster, MA 01473-1601

Mailing address

27 Nichols St
Westminster, MA 01473-1440
Phone (978) 874-6427

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Oct 10, 2024 through Oct 10, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4473MAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811065824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 NICHOLS ST",
            "city": "WESTMINSTER",
            "state": "MA",
            "postal_code": "014731440",
            "telephone_number": "978-874-6427",
            "fax_number": "978-874-7457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 WYMAN RD",
            "city": "WESTMINSTER",
            "state": "MA",
            "postal_code": "014731601",
            "telephone_number": "978-874-6427",
            "fax_number": "978-874-7457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATA",
        "first_name": "JODY",
        "middle_name": "LYNN",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "4473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, MA

Sources for this page

Verify at the official NPI Registry.