MR. JOSEPH ODOM (NPI# 1669852778) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669852778 |
| Entity Type | Individual |
| Full Name | MR. JOSEPH ODOM |
| Credential | LADC 1 #1394 |
| Practice Address |
43 Old Colony Road Quincy MA 02171 |
| Mailing Address |
99 Wayland Ave Ste 100 Providence RI 02906-4314 |
| Practice Telephone | 6179341136 |
| Practice Fax Number | 6178301224 |
| Mailing Telephone | 4013314250 |
| Mailing Fax Number | 4014215520 |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2015-06-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| Y | 101Y00000X | Counselor | 1394 | MA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 1890832 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295856177 | Joseph Odom | Acupuncturist | 22 Belle Avenue, #8, San Anselmo, CA 94960 | 2007-04-02 |
| 1073518528 | Joseph Hamilton Odom | Pharmacist | 1608 Main St, Conway, SC 29526-3572 | 2005-06-20 |
| Street Address |
43 OLD COLONY ROAD |
| City | QUINCY |
| State | MA |
| Zip Code | 02171 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730661190 | Yvonne Ann Roth | Social Worker | 1 Enterprise Drive, Quincy, MA 02171 | 2018-09-03 |
| 1902397631 | Kristen Spain | Registered Nurse | 110 West Squantum St., North Quincy, MA 02171 | 2018-05-29 |
| 1760984777 | Oumaima Mansouri | Counselor | 110 West Squantum Street, Quincy, MA 02171 | 2018-03-06 |
| 1386163699 | Sophonie Belizaire | Assistant Behavior Analyst | South Shore Mental Health, 500 Victory Rd., Quincy, MA 02171 | 2017-09-18 |
| 1306209168 | Katherine R Standish | Family Medicine | 110 W Squantum St Ste 8, North Quincy, MA 02171 | 2016-03-30 |
| 1578825436 | Hoi Yuk Pang | Counselor | 1 Billings Rd, Quincy, MA 02171 | 2012-06-15 |
| 1275862526 | Naeemah Tahira Smith | Counselor | 210a Quincy Shore Dr, Quincy, MA 02171 | 2009-12-16 |
| 1386876779 | Mark Everds | Counselor | 97 Holmes Street, 2nd Floor, North Quincy, MA 02171 | 2009-08-18 |
| 1306014741 | Ping-chiu Chan | Acupuncturist | Chinese Medical Center, 38 Billings Road, Quincy, MA 02171 | 2008-02-20 |
| 1679774988 | Mary Anne Mckendall | Internal Medicine | One Enterprise Drive, Blue Cross Blue Shield of Massachusetts, Quincy, MA 02171 | 2007-05-31 |
| Find all providers in zip 02171 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396389920 | Agnes L Denson | Counselor | 66 Kenon Ln, Quincy, FL 32352-6924 | 2019-11-06 |
| 1174166532 | Jennifer Johnson | Counselor | 4355 High Bridge Rd, Quincy, FL 32351-6128 | 2019-10-17 |
| 1225686348 | Krystal Marie Gottilla | Counselor | 48a Bay State Rd, Quincy, MA 02171-1512 | 2019-09-02 |
| 1346723202 | Robert Eugene Bates | Counselor | 203 Central Ave So, Quincy, WA 98848 | 2018-09-07 |
| 1033691100 | Hector Ismael Zavala | Counselor | 203 So. Central Ave, Quincy, WA 98848 | 2018-09-05 |
| 1871097220 | Maricella Salazar | Counselor | 203 South Central, Quincy, WA 98848 | 2018-03-21 |
| 1760984777 | Oumaima Mansouri | Counselor | 110 West Squantum Street, Quincy, MA 02171 | 2018-03-06 |
| 1144737636 | James Kenneth Cheatham Jr. | Counselor | 80 Quarry St Apt 3, Quincy, MA 02169-4173 | 2018-01-05 |
| 1831612860 | Matthew Ward | Counselor | 270 County Hospital Rd. #109, Quincy, CA 95971 | 2017-07-21 |
| 1982132577 | Madison Gonzalez | Counselor | 203 So. Central, Quincy, WA 98848 | 2017-05-26 |
| Find all providers in QUINCY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.