Individual provider Active NPI

Angela Renee Carlson, MA

  • Counselor
  • Allston, MA
National Provider Identifier
1922666981
Registry record updated Jun 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
14 Fordham Rd
Allston, MA 02134-3000
Phone
(617) 782-6460
NPI assigned
Jun 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

14 Fordham Rd
Allston, MA 02134-3000

Mailing address

14 Fordham Rd
Allston, MA 02134-3000
Phone (617) 782-6460

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
I20240124004032 MA Practitioner - Mental Health Counselor 9537512611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tmin Services IncGroup PAC ID 0840657862, 42 clinicians

Practice addresses (Care Compare)

800 District Ave
Suite 520
Burlington, MA 01803-5060
Phone (781) 338-7350

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Tmin Services, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

800 District Ave
Ste 520
Burlington, MA 01803
Phone (781) 338-7350

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": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559606400000",
    "number": "1922666981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 FORDHAM RD",
            "city": "ALLSTON",
            "state": "MA",
            "postal_code": "021343000",
            "telephone_number": "617-782-6460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 FORDHAM RD",
            "city": "ALLSTON",
            "state": "MA",
            "postal_code": "021343000",
            "telephone_number": "617-782-6460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "ANGELA",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-04",
        "last_updated": "2019-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allston, MA

Sources for this page

Verify at the official NPI Registry.