SELF (NPI# 1568814390) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568814390 |
| Entity Type | Organization |
| Organization Name | SELF |
| Practice Address |
19 Merrick Ave Apt 1 Springfield MA 01109-4324 |
| Mailing Address |
19 Merrick Ave Springfield MA 01109-4324 |
| Practice Telephone | 4132445624 |
| Mailing Telephone | 4132445624 |
| Enumeration Date | 2016-07-05 |
| Last Update Date | 2016-07-05 |
| Authorized Official Name | LUIS RIVERA (COUNSELOR) |
| Authorized Official Telephone | 4132445624 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508319666 | Self | Community/Behavioral Health | 117 Valley St, Glenwood, IA 51534-1024 | 2016-07-25 |
| 1740655471 | Self | Clinic/Center | 7627 Key West Dr, Parma, OH 44134-6624 | 2015-12-07 |
| 1215333901 | Self | Physical Therapist | 410 Jason Dr, Richmond, KY 40475-2291 | 2014-11-07 |
| 1659789915 | Self | Home Health | 33803 Electric Blvd, E4, Avonlake, OH 44012 | 2014-07-30 |
| 1811334758 | Self | Skilled Nursing Facility | 4 Spruce Rd, Amityville, NY 11701-1019 | 2013-06-02 |
| 1699019786 | Self | Health Maintenance Organization | 10136 Amigo Ave, Northridge, CA 91324-1301 | 2012-11-15 |
| 1861781759 | Self | Licensed Practical Nurse | 29 Heberton Rd, Rochester, NY 14622-2405 | 2011-03-31 |
| 1649599135 | Self | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1965 Lafayette Ave, Apt. 1g, Bronx, NY 10473-2502 | 2010-05-23 |
| 1912372822 | Self | Community/Behavioral Health | 5010 E Shea Blvd Ste D202, Scottsdale, AZ 85254-4570 | 2015-12-02 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SELF | 214 Ceret Ct Sw, Vienna, VA 22180-6210 |
| Colorado Business Entities | Self !mprovment, LLC | 3416 White Oak Ln, Highlands Ranch, CO 80129 |
| Virginia Business Entities | SELF & LOVING CONSTRUCTION INC. | 140 Claughton Wright Lane, Lottsburg, Virginia 22511 |
| System for Award Management (SAM) Entities | SELF & SELF GENERAL CONTRACTORS | 494 Grv St N, Dahlonega, GA 30533-0432 |
| System for Award Management (SAM) Entities | SELF --- SUPPORT FOR EARLY LEARNING & FAMILIES | 12214 Se Mill Plain Blvd Ste 203, Vancouver, WA 98684-6019 |
| New York State Corporations | SELF ABLE, INC. | 302 N Fulton Avenue, Lindenhurst, Ny 11757 |
| Washington State Corporations | SELF ACCESS STORAGE, LLC | 102 Myers St, Rainier, WA 98576 |
| Virginia Business Entities | Self Actualization Counseling Services LLC | 1220 Geranium Crescent, Virginia Beach, Virginia 23453 |
| Indiana Business Entities | SELF ADHERING PRODUCTS INC | 457 Circle Freeway Dr, Cincinnati, OH 45246 |
| Washington State Corporations | SELF ADHESIVE RECORDS INC. | 3835 34th Ave W #2 Po Box 99711, Seattle, WA 98199 |
| Street Address |
19 MERRICK AVE APT 1 |
| City | SPRINGFIELD |
| State | MA |
| Zip Code | 01109-4324 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720479892 | Ethan Chase | Dentist | 555 State Street, Dental Dreams, Springfield, MA 01109 | 2015-02-11 |
| 1043591423 | Victoria A Jones | Counselor | 1104 Street Street, Suite 2d, Springfield, MA 01109 | 2011-08-30 |
| 1093043879 | Lee Ann Callagher | Occupational Therapist | 807 Wilbraham Rd., Springfield, MA 01109 | 2009-12-07 |
| 1740424993 | Pamela Joan Aselton | Nurse Practitioner | 263 Alden Street, Springfield College Health Service, Springfield, MA 01109 | 2009-04-30 |
| 1225642507 | Emma V Slater | Student in an Organized Health Care Education/Training Program | 263 Alden St, Springfield, MA 01109 | 2020-09-03 |
| 1184253239 | Hye Young Shin | Dentist | 555 State St, Springfield, MA 01109 | 2020-04-01 |
| 1225662992 | Mary Catherine Becker | Student in an Organized Health Care Education/Training Program | 263 Alden Street, Springfield, MA 01109 | 2020-03-02 |
| 1235630856 | Kathryn O'brien | Student in an Organized Health Care Education/Training Program | 11 Wilbraham Rd, Springfield, MA 01109 | 2018-02-28 |
| 1174074736 | Candace Griffith | Counselor | 140 High St., Suite 230, Springfield, MA 01109 | 2016-10-19 |
| 1356730279 | Pedro Ferrer | Counselor | 332 Birnie Ave, Springfield, MA 01109 | 2015-01-15 |
| Find all providers in zip 01109 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114496916 | Transformations Therapy Center LLC | Clinic/Center | 110 Hillside Ave Ste 301, Springfield, NJ 07081-3007 | 2018-11-21 |
| 1851860209 | Preferred Family Healthcare, Inc | Clinic/Center | 3300 S National Ave Ste 500, Springfield, MO 65807-7343 | 2018-11-15 |
| 1982129722 | Solid Ground Counseling Services, LLC | Clinic/Center | 2515 W Allen Dr, Springfield, MO 65810-1300 | 2017-08-12 |
| 1538767090 | Camelot Care Centers, LLC | Clinic/Center | 2144 S Macarthur Blvd, Springfield, IL 62704-4502 | 2020-10-15 |
| 1609483049 | G Street Integrated Health | Clinic/Center | 1435 G St, Springfield, OR 97477-4113 | 2020-09-29 |
| 1225463136 | Colby Wang, Md, LLC | Clinic/Center | 636 W Republic Rd, B-112, Springfield, MO 65807-5818 | 2013-09-10 |
| 1174868442 | Ct- Family Care Services, LLC | Clinic/Center | 155 Maple St, Unit 204, Springfield, MA 01105-2649 | 2012-11-28 |
| 1922253947 | The Children's Center - Medical Services | Clinic/Center | 5220 S 6th Street Rd, Suite 2200, Springfield, IL 62703-5735 | 2008-11-18 |
| 1457505125 | Mental Health Centers of Central Illinois | Clinic/Center | 5220 S 6th Street Rd, Suite 2400, Springfield, IL 62703-5735 | 2008-11-07 |
| 1073706602 | Zoe Alison Burch | Clinic/Center | 15 E Pleasant St, Springfield, OH 45506-2201 | 2007-08-27 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 01109 |
Please comment or provide details below to improve the information on SELF.
| 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.