Individual provider Active NPI

Kelley Anne Costello

  • Marriage & Family Therapist
  • Taunton, MA
National Provider Identifier
1831539717
Registry record updated Mar 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1683 Issued in MA
Practice address
135 Washington St
Taunton, MA 02780-2582
Phone
(508) 615-6628
NPI assigned
Jun 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1683 MA Primary

Addresses

Primary practice location

135 Washington St
Taunton, MA 02780-2582

Mailing address

135 Washington St
Taunton, MA 02780-2582
Phone (508) 615-6628

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
I20240610000280 MA Practitioner - Marriage and Family Therapist 5294277927 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1683MAMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kelley Costello, LMFT, Inc. Marriage & Family Therapist CurrentSince Oct 4, 2020 Accepting new patients
High Point Treatment Center Inc. CurrentSince Apr 22, 2024 Accepting new patients

Locations

10 S Main St
Ste 207
Attleboro, MA 02703
Phone (774) 322-1306

30 Meadowbrook Rd
Brockton, MA 02301
Phone (508) 408-6190

72 Kilburn St
New Bedford, MA 02740
Phone (774) 213-8448

1233 State Rd
Plymouth, MA 02360
Phone (508) 224-6527

61 Industrial Park Rd
Plymouth, MA 02360
Phone (508) 746-8977

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": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553040000000",
    "number": "1831539717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 WASHINGTON ST",
            "city": "TAUNTON",
            "state": "MA",
            "postal_code": "027802582",
            "telephone_number": "508-615-6628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 WASHINGTON ST",
            "city": "TAUNTON",
            "state": "MA",
            "postal_code": "027802582",
            "telephone_number": "508-615-6628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "KELLEY",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-25",
        "last_updated": "2019-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MA",
            "license": "1683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taunton, MA

Sources for this page

Verify at the official NPI Registry.