NORTH SUFFOLK MENTAL HEALTH ASSOCIATION, INC. (NPI# 1255481107) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255481107 |
| Entity Type | Organization |
| Organization Name | NORTH SUFFOLK MENTAL HEALTH ASSOCIATION, INC. |
| Practice Address |
530 Border St East Boston MA 02128-2432 |
| Mailing Address |
301 Broadway Chelsea MA 02150-2807 |
| Practice Telephone | 6175696560 |
| Practice Fax Number | 6175691856 |
| Mailing Telephone | 6178894860 |
| Mailing Fax Number | 6178894635 |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JACKIE K. MOORE (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 6179127910 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD1600X |
Clinic/Center Specialization: Developmental Disabilities |
CERTIFIED BY DPH | MA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | NEIGHBORHOOD HEALTH PLAN | 0006844 | 01 |
| MA | HARVARD PILGRIM | 612900 | 01 |
| MA | TUFTS HEALTH PLAN | 708502 | 01 |
| MA | 1800515 | 05 | |
| CT | CIGNA | 3836587 | 01 |
| CT | AETNA-US HEALTHCARE | 821870 | 01 |
| MA | BMC HEALTHNET-EI | 00000005443 | 01 |
| MA | BLUE CROSS OF MA | EI0002 | 01 |
| MA | NETWORK HEALTH | 99625101 | 01 |
| TRICARE-CHAMPUS | 42317215002 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740209881 | North Suffolk Mental Health Association, Inc. | Clinic/Center | 14 Porter St, East Boston, MA 02128-2116 | 2006-07-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | NORTH SUFFOLK MENTAL HEALTH ASSOCIATION, INC. | 301 Broadway, Chelsea, MA 02150-2807 |
| Massachusetts Corporations | NORTH SUFFOLK MENTAL HEALTH ASSOCIATION, INC. | 301 Broadway, Chelsea, MA 02150 |
| Street Address |
530 BORDER ST |
| City | EAST BOSTON |
| State | MA |
| Zip Code | 02128-2432 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174683718 | Shannon Byrnside | Social Worker | 530 Border St, East Boston, MA 02128-2432 | 2006-12-12 |
| 1649421520 | Sharon Lea Crow | Social Worker | 530 Border St, East Boston, MA 02128-2432 | 2008-10-09 |
| 1891994414 | Mary Katherine Muse-fisher | Counselor | 530 Border St, Harbor Area Early Childhood Services, East Boston, MA 02128-2432 | 2007-07-13 |
| 1740487107 | Ashley Quici Cross | Case Manager/Care Coordinator | 530 Border St, East Boston, MA 02128-2432 | 2007-06-29 |
| 1457558819 | Colleen Marie Mccarthy | Case Manager/Care Coordinator | 530 Border St, East Boston, MA 02128-2432 | 2007-06-29 |
| 1578760948 | Kimberly Ann Carvalho | Case Manager/Care Coordinator | 530 Border St, East Boston, MA 02128-2432 | 2007-06-29 |
| 1457569899 | Celsa Ida Hernandez | Case Manager/Care Coordinator | 530 Border St, East Boston, MA 02128-2432 | 2007-05-18 |
| 1891914313 | Yi-chun Lin | Case Manager/Care Coordinator | 530 Border St, East Boston, MA 02128-2432 | 2007-04-24 |
| 1710104039 | Sarah Elizabeth Dybizbanski | Case Manager/Care Coordinator | 530 Border St, East Boston, MA 02128-2432 | 2007-04-19 |
| 1023234721 | Hilda R Gomez | Case Manager/Care Coordinator | 530 Border St, East Boston, MA 02128-2432 | 2007-04-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417562976 | Kristen Pompey | Speech-Language Pathologist | 244 Paris St Apt 3e, East Boston, MA 02128 | 2020-09-11 |
| 1073122271 | Candice Elene Newmyer | Nurse Practitioner | East Boston Neighborhood Health Center, 10 Gove St, East Boston, MA 02128 | 2020-07-24 |
| 1881155414 | Lucas Felipe Bastos Horta | Student in an Organized Health Care Education/Training Program | 725 Albany Street, Shapiro Primary Care, Precepting Room, Boston, MA 02128 | 2019-03-27 |
| 1245729763 | Josie A Kramer | Registered Nurse | 213 Webster Street, Unit 1, Boston, MA 02128 | 2018-05-10 |
| 1457875775 | Bremen Physical Therapy | Clinic/Center | 464 Bremen St. Suite 4b, East Boston, MA 02128 | 2017-07-28 |
| 1174907588 | Vivian Karina Ibanez | Specialist | 130 Condor Street, East Boston, MA 02128 | 2015-07-15 |
| 1326459546 | Excel Physical Therapy, Inc. | Clinic/Center | 2 Neptune Rd Suite 171, East Boston, MA 02128 | 2014-05-09 |
| 1427394824 | D.a.w., L.L.C. | Durable Medical Equipment & Medical Supplies | 20 Maverick Sq, East Boston, MA 02128 | 2012-12-13 |
| 1356600019 | Rebekah Bronwyn Sheppard | Doula | 253 Webster Street, Boston, MA 02128 | 2012-05-15 |
| 1629340484 | Shahi Lavail Smart Sr. | Counselor | 512 Border Street, #d, East Boston, MA 02128 | 2012-02-08 |
| Find all providers in zip 02128 | ||||
| Taxonomy Code | 261QD1600X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Developmental Disabilities |
| An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.). |
| Notes: [7/1/2003: new] |
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| 1659869352 | A1 Autism Consultants | Clinic/Center | 330 Sunderland Rd Unit 76, Worcester, MA 01604-2529 | 2018-04-27 |
| 1821203365 | Minute Man Arc for Human Services, Inc. | Clinic/Center | 130c Baker Avenue Ext, Concord, MA 01742-2121 | 2007-05-10 |
| 1043336407 | Baroco Corporation | Clinic/Center | 4 Westview Rd, Pittsfield, MA 01201-8021 | 2007-03-21 |
| 1063538445 | Baroco Corporation | Clinic/Center | 450 Cottage St, Springfield, MA 01104-3355 | 2007-03-21 |
| 1346366507 | Baroco Corporation | Clinic/Center | 64 Roanoke Ave, West Springfield, MA 01089-3710 | 2007-03-21 |
| 1265558621 | Baroco Corporation | Clinic/Center | 115 Wayside Ave, West Springfield, MA 01089-1317 | 2007-03-21 |
| 1396771820 | Douglas A. Thom Clinic, Inc. | Clinic/Center | 126 Phoenix Ave, Building #2, Lowell, MA 01852-4931 | 2006-06-25 |
| 1306465869 | Carter House LLC | Clinic/Center | 125 Sutton Rd, Needham, MA 02492-3214 | 2020-04-14 |
| 1528500303 | Bierman Aba, Inc. | Clinic/Center | 145 Rosemary St, Suite K, Needham Heights, MA 02494-3238 | 2016-11-10 |
| Find all providers with the same taxonomy | ||||
| City | EAST BOSTON |
| Zip Code | 02128 |
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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.