Individual provider Active NPI

Paula Jean Spivey

  • Mental Health Counselor
  • Gardner, MA
National Provider Identifier
1811175342
Registry record updated Feb 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
S33121608 Issued in MA
Practice address
31 Lake St
Gardner, MA 01440-3879
Phone
(978) 632-9400
NPI assigned
Feb 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2008

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 S33121608 MA Primary

Addresses

Primary practice location

31 Lake St
Gardner, MA 01440-3879

Mailing address

141 Lakeshore Dr
Winchendon, MA 01475-1093
Phone (978) 297-2149

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
I20240124001976 MA Practitioner - Mental Health Counselor 1759734981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinical and Support Options, IncGroup PAC ID 6608835350, 103 clinicians

Practice addresses (Care Compare)

205 School St
Suite 301
Gardner, MA 01440-2781
Phone (978) 632-9400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S33121608MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical & Support Options, Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

205 School St
Ste 301
Gardner, MA 01440
Phone (978) 488-8888

1 Arch Pl
Greenfield, MA 01301
Phone (413) 773-1000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202256000000",
    "number": "1811175342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 LAKESHORE DR",
            "city": "WINCHENDON",
            "state": "MA",
            "postal_code": "014751093",
            "telephone_number": "978-297-2149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 LAKE ST",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014403879",
            "telephone_number": "978-632-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPIVEY",
        "first_name": "PAULA",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-06",
        "last_updated": "2008-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "S33121608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardner, MA

Sources for this page

Verify at the official NPI Registry.