CHARLES YETMAN (NPI# 1184177354) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184177354 |
| Entity Type | Individual |
| Full Name | CHARLES YETMAN |
| Credential | LADC 1, SAP |
| Practice Address |
1400 Hancock St Suite 2 Quincy MA 02169-5233 |
| Practice Telephone | 6177740331 |
| Practice Fax Number | 6177740336 |
| Mailing Telephone | 6177740331 |
| Mailing Fax Number | 6177740336 |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2016-07-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
1978 | MA | Behavioral Health & Social Service Providers |
| Street Address |
1400 HANCOCK ST SUITE 2 |
| City | QUINCY |
| State | MA |
| Zip Code | 02169-5233 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417300682 | Mary Kate Collins | Counselor | 1400 Hancock St, Suite 2, Quincy, MA 02169-5233 | 2016-07-22 |
| 1841726460 | Damien Jude Turini | Counselor | 1400 Hancock St, 2nd Floor, Quincy, MA 02169-5233 | 2017-05-02 |
| 1568916831 | Jeanne Melvin | Counselor | 1400 Hancock St, Suite 2, Quincy, MA 02169-5233 | 2016-08-04 |
| 1790238723 | Francis Carey | Counselor | 1400 Hancock St, Suite 2, Quincy, MA 02169-5233 | 2016-07-26 |
| 1427501600 | Judith A. Sealey | Counselor | 1400 Hancock St, 2nd Flr, Quincy, MA 02169-5233 | 2016-07-25 |
| 1508319799 | Courtney Daruszka | Counselor | 1400 Hancock St, 2nd Floor, Quincy, MA 02169-5233 | 2016-07-25 |
| 1760935936 | David Morrison | Counselor | 1400 Hancock St, Suite 2, Quincy, MA 02169-5233 | 2016-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902427933 | Trinasia Jones | Counselor | 80 Quarry Street, 3, Quincy, MA 02169 | 2020-04-30 |
| 1164060778 | Bid-milton Physician Associates Inc | Clinic/Center | 100 Walter J. Hannon Pkwy, Quincy, MA 02169 | 2019-12-13 |
| 1669028064 | Renee Yvette Belisle | Occupational Therapist | 1266 Furnance Brook Parkway, Suite #100b, Quincy, MA 02169 | 2019-08-13 |
| 1952953713 | Phuc Thi Diem Ho | Registered Nurse | 18 Rustic Place, Quincy, MA 02169 | 2019-07-11 |
| 1518451939 | Lucille Jordan | Social Worker | 1175 Sea St, Quincy, MA 02169 | 2018-06-19 |
| 1326567447 | Tara Barney | Counselor | 290 Quarry Street Apt. 112, Quincy, MA 02169 | 2017-09-11 |
| 1295251007 | Iona Dental, P.C. (parent Organization) | Dentist | 10 Granite Street, Unit - 4c, Quincy, MA 02169 | 2017-08-15 |
| 1730610247 | Amy S. Chung | Family Medicine | 100 Walter J. Hannon Parkway, Quincy, MA 02169 | 2017-03-26 |
| 1205377314 | Wing Man Ting | Counselor | 2 Moon Island Road, Quincy, MA 02169 | 2017-03-09 |
| 1740726223 | Cameron James Dumas | Pharmacist | 21 23 Stanhope Street, Boston, MA 02169 | 2017-01-09 |
| Find all providers in zip 02169 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003434036 | Steven James Gibbons | Counselor | 85 Quincy Ave Ste B, Quincy, MA 02169-6764 | 2020-07-07 |
| 1538786553 | Nychelle Waiters | Counselor | 339 E Jefferson St, Quincy, FL 32351-2531 | 2020-06-26 |
| 1114542354 | Kelly D Walker | Counselor | 1942 W King St, Quincy, FL 32351-2057 | 2020-06-13 |
| 1659903128 | Haley Clifford | Counselor | 85 Quincy Ave, Quincy, MA 02169-6763 | 2020-02-12 |
| 1710430178 | Arlene Small | Counselor | 1419 Hancock St Ste 301, Quincy, MA 02169-5250 | 2016-08-02 |
| 1174908073 | John Edward Christian | Counselor | 1400 Hancock St Fl 2, Quincy, MA 02169-5233 | 2015-07-21 |
| 1083095533 | Thomas Patrick Fowkes | Counselor | 1233r Hancock St, Quincy, MA 02169-4342 | 2015-06-10 |
| 1346620119 | Justin R Moore | Counselor | 10 Mayor Thomas J Mcgrath Hwy, Quincy, MA 02169-5312 | 2015-06-05 |
| 1578828034 | Frances M Velona | Counselor | 1 Soar Ct, Quincy, MA 02171-1058 | 2012-07-11 |
| 1770849010 | Christopher M Dorval | Counselor | 36 Miller Stile Rd, Quincy, MA 02169-5423 | 2012-04-11 |
| 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.