Active NPI
Stacey Rose Shimkus, LMHC
- Mental Health Counselor
- Burlington, MA
National Provider Identifier
1881477933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 4730
- Practice address
- 101 Cambridge St Ste 230
Burlington, MA 01803-3767 - Phone
- (978) 222-3121
- NPI assigned
- Aug 14, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 4730 | MA | Primary |
Addresses
Primary practice location
101 Cambridge St Ste 230
Burlington, MA 01803-3767
Mailing address
101 Cambridge St Ste 230
Burlington, MA 01803-3767
Phone (978) 222-3121
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4730 | MA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Counseling Associates of Salem Andover LLC | Mental Health | Past | Accepting new patients |
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.
-
- Mental Health Counselor
- Andover, MA
- NPI 1013246602
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691971200000",
"number": "1881477933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 CAMBRIDGE ST STE 230",
"city": "BURLINGTON",
"state": "MA",
"postal_code": "018033767",
"telephone_number": "978-222-3121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 CAMBRIDGE ST STE 230",
"city": "BURLINGTON",
"state": "MA",
"postal_code": "018033767",
"telephone_number": "978-222-3121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIMKUS",
"first_name": "STACEY",
"middle_name": "ROSE",
"credential": "LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-08-14",
"last_updated": "2023-08-14",
"certification_date": "2023-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "4730",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burlington, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.