Individual provider Active NPI

Carolyn Emond

  • Mental Health Counselor
  • Sagamore Beach, MA
National Provider Identifier
1811642127
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
12590479-6010 Issued in NY
Practice address
114 State Rd
Sagamore Beach, MA 02562-2317
Phone
(508) 333-1375
Fax
(508) 445-5373
NPI assigned
Feb 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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 12590479-6010 NY Primary

Addresses

Primary practice location

114 State Rd
Sagamore Beach, MA 02562-2317

Mailing address

331 W 2700 S
South Salt Lake, UT 84115-2904
Phone (801) 678-3317

Other practice location 1

331 W 2700 S
South Salt Lake, UT 84115-2904
Phone (801) 678-3317

Other practice location 2

1818 State Rd
Rt 49
Constantia, NY 13044
Phone (801) 678-3317

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12590479-6010NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sagamore Counseling CurrentSince Oct 1, 2019 Accepting new patients
Saint Anthony House Treatment Programs Mental Health Past Accepting new patients

Locations

258 Main St
Ste C3
Buzzards Bay, MA 02532
Phone (508) 333-1375

345 Old Plymouth Rd
Sagamore Beach, MA 02562
Phone (508) 333-1375

114 State Rd
Sagamore Beach, MA 02562
Phone (508) 333-1375

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": "1644883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1811642127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 W 2700 S",
            "city": "SOUTH SALT LAKE",
            "state": "UT",
            "postal_code": "841152904",
            "telephone_number": "801-678-3317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 STATE RD",
            "city": "SAGAMORE BEACH",
            "state": "MA",
            "postal_code": "025622317",
            "telephone_number": "508-333-1375",
            "fax_number": "508-445-5373"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "331 W 2700 S",
            "address_purpose": "LOCATION",
            "city": "South Salt Lake",
            "state": "UT",
            "postal_code": "841152904",
            "country_code": "US",
            "telephone_number": "801-678-3317",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1818 State Rd",
            "address_2": "Rt 49",
            "address_purpose": "LOCATION",
            "city": "Constantia",
            "state": "NY",
            "postal_code": "13044",
            "country_code": "US",
            "telephone_number": "801-678-3317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EMOND",
        "first_name": "CAROLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-15",
        "last_updated": "2024-11-04",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "12590479-6010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sagamore Beach, MA

Sources for this page

Verify at the official NPI Registry.