Individual provider Active NPI

Mary Ruth Kolodny

  • Counselor
  • Worcester, MA
National Provider Identifier
1992066187
Registry record updated Jun 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
255 Park Ave
Worcester, MA 01609-1953
Phone
(508) 799-0688
NPI assigned
Jun 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2012

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

255 Park Ave
Worcester, MA 01609-1953

Mailing address

255 Park Ave
Worcester, MA 01609-1953

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1338768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338768000000",
    "number": "1992066187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 PARK AVE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016091953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 PARK AVE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016091953",
            "telephone_number": "508-799-0688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLODNY",
        "first_name": "MARY",
        "middle_name": "RUTH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-04",
        "last_updated": "2012-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.