NPIMap

Individual provider Active NPI

Teresa Connors-Macmillan

  • Mental Health Counselor
  • Petersham, MA
National Provider Identifier
1922357664
Registry record updated Oct 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
5818 Issued in MA
Practice address
211 N Main St
Petersham, MA 01366-9503
Phone
(978) 724-0010
NPI assigned
Sep 7, 2012
Last updated
Oct 30, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2019

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 5818 MA Primary

Addresses

Primary practice location

211 N Main St
Petersham, MA 01366-9503

Mailing address

211 N Main St
Petersham, MA 01366-9503

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

LicenseStateTypeSpecialty
5818MAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The McLean Hospital Corporation CurrentSince Nov 3, 2019 Accepting new patients
Henry Heywood Memorial Hospital PastSince Nov 3, 2019 Accepting new patients

Locations

211 N Main St
Petersham, MA 01366
Phone (978) 724-0010

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1346976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572393600000",
    "number": "1922357664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 N MAIN ST",
            "city": "PETERSHAM",
            "state": "MA",
            "postal_code": "013669503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 N MAIN ST",
            "city": "PETERSHAM",
            "state": "MA",
            "postal_code": "013669503",
            "telephone_number": "978-724-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNORS-MACMILLAN",
        "first_name": "TERESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-07",
        "last_updated": "2019-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "5818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petersham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.