Active NPI
Marissa Nicole Gurello
- Counselor
- Roslindale, MA
National Provider Identifier
1952912040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- LMHC5000961
- Practice address
- 780 American Legion Hwy
Roslindale, MA 02131-3908 - Phone
- (617) 469-8500
- NPI assigned
- Aug 12, 2020
- Last updated
- Oct 19, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | LMHC5000961 | MA | Primary |
| Mental Health Counselor | 101YM0800X | NU |
Addresses
Primary practice location
780 American Legion Hwy
Roslindale, MA 02131-3908
Mailing address
48 N St Apt 1
Boston, MA 02127-2305
Phone (631) 603-7549
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2020
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
600 3Rd Ave
FL 2
New York, NY 10016-1909
600 3Rd Ave FL
Suite 2
New York, NY 10016-1919
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMHC5000961 | MA | MD | Counselor |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Thriving Center of Psychology
- Mental Health Clinic/Center (Including Community Mental Health Center)
- New York, NY
- NPI 1932975919
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697673600000",
"number": "1952912040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "48 N ST APT 1",
"city": "BOSTON",
"state": "MA",
"postal_code": "021272305",
"telephone_number": "631-603-7549"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "780 AMERICAN LEGION HWY",
"city": "ROSLINDALE",
"state": "MA",
"postal_code": "021313908",
"telephone_number": "617-469-8500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GURELLO",
"first_name": "MARISSA",
"middle_name": "NICOLE",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-12",
"last_updated": "2023-10-19",
"certification_date": "2023-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MA",
"license": "LMHC5000961",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roslindale, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.