NPIMap

Organization Active NPI

Intentional Self. LLC

  • Community/Behavioral Health Agency
  • Stoughton, MA
National Provider Identifier
1972924371
Registry record updated Jan 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
5509 Issued in MA
Legal business name
INTENTIONAL SELF. LLC
Practice address
6 Cabot PL
Suite # 6
Stoughton, MA 02072-4625
Phone
(781) 767-0008
NPI assigned
Jan 2, 2014
Last updated
Jan 2, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2014

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

Authorized official

Name
Ms. Sandra C Range, LMHCNPI 1053412882
Title
Owner
Phone
(781) 767-0008

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 5509 MA Primary

Addresses

Primary practice location

6 Cabot PL
Suite # 6
Stoughton, MA 02072-4625

Mailing address

141 Memorial Pkwy
PMB 211
Randolph, MA 02368-4511
Phone (781) 767-0008

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1388620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388620800000",
    "number": "1972924371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 MEMORIAL PKWY",
            "address_2": "PMB 211",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023684511",
            "telephone_number": "781-767-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 CABOT PL",
            "address_2": "SUITE # 6",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "020724625",
            "telephone_number": "781-767-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTENTIONAL SELF. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-02",
        "last_updated": "2014-01-02",
        "status": "A",
        "authorized_official_last_name": "RANGE",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-767-0008",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MA",
            "license": "5509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stoughton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2014; 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.