Individual provider Active NPI

John D Leavitt, MSW

  • Addiction (Substance Use Disorder) Counselor
  • South Boston, MA
National Provider Identifier
1972675320
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
1028970 Issued in MA
Practice address
210 Old Colony Ave
South Boston, MA 02127-2413
Phone
(617) 268-5000
Fax
(617) 268-5008
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1028970 MA Primary

Addresses

Primary practice location

210 Old Colony Ave
South Boston, MA 02127-2413

Mailing address

210 Old Colony Ave
South Boston, MA 02127-2413
Phone (617) 268-5000

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1028970MAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Assessment and Treatment Associates, LLC CurrentSince Dec 12, 2011 Accepting new patients
Mashpee Mental Health Center, Inc. CurrentSince Dec 12, 2011 Accepting new patients
South Bay Mental Health Center, Inc. PastSince Nov 18, 2019 Accepting new patients
Brighton Family Practice, Inc Past Accepting new patients
SB Transitional Sub, LLC PastSince May 17, 2021 Accepting new patients
Gavin Foundation PastSince Jan 29, 2023 Accepting new patients
Preventive Medicine Associates Past Accepting new patients
High Point Treatment Center Inc. PastSince Jul 24, 2022 Accepting new patients

Locations

400 Nathan Ellis Hwy
Ste 1B
Mashpee, MA 02649
Phone (401) 624-7281

Organizations & group practices 8

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1972675320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 OLD COLONY AVE",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "021272413",
            "telephone_number": "617-268-5000",
            "fax_number": "617-268-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 OLD COLONY AVE",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "021272413",
            "telephone_number": "617-268-5000",
            "fax_number": "617-268-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAVITT",
        "first_name": "JOHN",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "1028970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.

Verify at the official NPI Registry.