Active NPI
Selina Lang
- Mental Health Counselor
- Brookline, MA
National Provider Identifier
1932702586
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 12021
- Practice address
- 1269 Beacon St Ste 2
Brookline, MA 02446-5248 - Phone
- (617) 934-1974
- NPI assigned
- Nov 17, 2020
- Sex
- Female
- Sole proprietor
- No
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 | 12021 | MA | Primary |
Addresses
Primary practice location
1269 Beacon St Ste 2
Brookline, MA 02446-5248
Mailing address
1000 Jefferson St Ste 2C
Lynchburg, VA 24504-1724
Phone (617) 934-1974
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 |
|---|---|---|---|
| 12021 | MA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrive Counseling LLC | Mental Health | Current | Accepting new patients |
Locations
1269 Beacon St
Ste 2
Brookline, MA 02446
Phone (617) 934-1974
1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263
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": "1605571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605571200000",
"number": "1932702586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 JEFFERSON ST STE 2C",
"city": "LYNCHBURG",
"state": "VA",
"postal_code": "245041724",
"telephone_number": "617-934-1974"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1269 BEACON ST STE 2",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024465248",
"telephone_number": "617-934-1974"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANG",
"first_name": "SELINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-17",
"last_updated": "2020-11-17",
"certification_date": "2020-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "12021",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookline, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.