WALTHAM BEHAVIORAL HEALTH LLC (NPI# 1427453000) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427453000 |
| Entity Type | Organization |
| Organization Name | WALTHAM BEHAVIORAL HEALTH LLC |
| Practice Address |
210 Bear Hill Rd Suite 202 Waltham MA 02451-1025 |
| Mailing Address |
210 Bear Hill Road Suite 202 Waltham MA 02451-1025 |
| Practice Telephone | 7819660070 |
| Practice Fax Number | 7819150755 |
| Mailing Telephone | 7819660070 |
| Mailing Fax Number | 7819150755 |
| Enumeration Date | 2014-10-25 |
| Last Update Date | 2020-01-06 |
| Authorized Official Name | MS. ELEFTHERIA TSAVOUSSIS (OWNER) |
| Authorized Official Telephone | 7819660070 |
| Authorized Official Credential | PMSCNSBC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 103TC0700X |
Psychologist Specialization: Clinical |
7194 | MA | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
113314 | MA | Behavioral Health & Social Service Providers |
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
205807 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
280722 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 364SP0809X |
Clinical Nurse Specialist Specialization: Psych/Mental Health, Adult |
175264 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 163WP0809X |
Registered Nurse Specialization: Psych/Mental Health, Adult |
Nursing Service Providers |
| Street Address |
210 BEAR HILL RD SUITE 202 |
| City | WALTHAM |
| State | MA |
| Zip Code | 02451-1025 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740270289 | Steven R Kanner | Internal Medicine | 210 Bear Hill Rd, Suite 304, Waltham, MA 02451-1025 | 2005-10-26 |
| 1942798533 | Martine Rossell | Counselor | 210 Bear Hill Rd, Suite 202, Waltham, MA 02451-1027 | 2018-04-29 |
| 1922451434 | Kristen Shannon | Counselor | 210 Bear Hill Rd, Suite 203, Waltham, MA 02451-1025 | 2016-07-20 |
| 1922441096 | Nicole Krysta Mayo | Occupational Therapist | 210 Bear Hill Rd, Waltham, MA 02451-1025 | 2013-04-09 |
| 1639454978 | Joe Gonzalez | Pharmacist | 210 Bear Hill Rd, Suite 400, Waltham, MA 02451-1025 | 2011-10-19 |
| 1902189996 | Michael Godek | Pharmacist | 210 Bear Hill Rd, Suite 401, Waltham, MA 02451-1025 | 2011-09-26 |
| 1649552274 | Gregory Youssef | Pharmacist | 210 Bear Hill Rd, Suite 400, Waltham, MA 02451-1025 | 2011-09-09 |
| 1679603757 | Steven R. Kanner, Md, LLC | Internal Medicine | 210 Bear Hill Rd, Suite 304, Waltham, MA 02451-1025 | 2007-03-06 |
| 1669439337 | Louisa Eileen Martin | Nurse Practitioner | 210 Bear Hill Rd, Suite 202, Waltham, MA 02451-1023 | 2006-04-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538719190 | Haeun Yang | Behavior Technician | 303 Wyman Street Suite 354, 344, 345, Waltham, MA 02451 | 2019-09-16 |
| 1982252599 | Sinclair Fashaw-braxton | Behavior Technician | 303 Wyman Street, Suite 354, 344, 345, Waltham, MA 02451 | 2019-08-27 |
| 1245715879 | Annie F Friedman | Social Worker | Extended Stay America, 32 4the Avenue, Waltham, MA 02451 | 2018-09-28 |
| 1760964118 | Elizabeth Boardman Harris | Social Worker | 60 Hickory Drive 4th Floor, Waltham, MA 02451 | 2018-09-02 |
| 1760960959 | Patriot Urgent Care Professionals, PC | General Practice | 1030 Main Street, Unit 2, Waltham, MA 02451 | 2018-07-31 |
| 1962998013 | Leighann Teresa Healy | Behavior Technician | 303 Wyman Suite 300, Waltham, MA 02451 | 2018-07-02 |
| 1194234492 | Bruna Rossi Hoffman | Dentist | 12 Grant Place, Apt 1, Waltham, MA 02451 | 2017-09-29 |
| 1265959159 | Matthew C Page-shelton | Counselor | 2208 Stearns Hill Road, Waltham, MA 02451 | 2017-08-23 |
| 1306380837 | Sherri Lynn Duquette | Behavior Technician | 1430 Main Street, Waltham, MA 02451 | 2016-12-19 |
| 1649628728 | Keren Matveev | Family Medicine | 75 Third Avenue, First Floor, Waltham, MA 02451 | 2016-05-30 |
| Find all providers in zip 02451 | ||||
| Taxonomy Code | 163WP0809X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health, Adult |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548878812 | Manabi Dhakal | Registered Nurse | 300 Tremont St Apt 2, Newton, MA 02458-2115 | 2020-07-22 |
| 1356969497 | Sarah Anne Mcnulty | Registered Nurse | Harrington Hospital, 100 South Street, Southbridge, MA 01550 | 2020-07-06 |
| 1114548294 | Patricia Anne Kenny | Registered Nurse | 20 Fosters Pt, Beverly, MA 01915-3912 | 2020-04-30 |
| 1467071001 | Lisa Ann Lamore | Registered Nurse | 296 Federal St, Greenfield, MA 01301-1932 | 2020-04-14 |
| 1881227965 | Kathleen L Tracy | Registered Nurse | 1 Hilary St, Boston, MA 02129-2507 | 2020-02-18 |
| 1346893187 | Lisa Napoli | Registered Nurse | 10 Menlo St, Brighton, MA 02135-2910 | 2019-07-22 |
| 1649838129 | Maame A Essoun | Registered Nurse | 33 Harley Dr Apt 4, Worcester, MA 01606-1740 | 2019-05-30 |
| 1063903714 | Natalie Baker | Registered Nurse | 2 Shepherds Hollow Rd, Leeds, MA 01053-9707 | 2018-05-29 |
| 1861997744 | Circle Care Behavioral Health LLC | Registered Nurse | 24 Spring Bars Rd Ste 3a, Falmouth, MA 02540-3938 | 2018-03-24 |
| 1831614692 | Henry Kengong Ntoro LLC | Registered Nurse | 144 Merrimack St Ste 441, Lowell, MA 01852-1709 | 2017-08-13 |
| Find all providers with the same taxonomy | ||||
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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.