COMMONWEALTH MENTAL HEALTH & WELLNESS CENTER


Address: 895 Blue Hill Ave Ste 1, Dorchester, MA 02124-2902
Phone: 6175068188

COMMONWEALTH MENTAL HEALTH & WELLNESS CENTER (NPI# 1588216378) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1588216378
Entity Type Organization
Organization Name COMMONWEALTH MENTAL HEALTH & WELLNESS CENTER
Practice Address 895 Blue Hill Ave Ste 1
Dorchester
MA 02124-2902
Practice Telephone 6175068188
Practice Fax Number 6175065039
Mailing Telephone 6175068188
Mailing Fax Number 6175065039
Enumeration Date 2019-07-11
Last Update Date 2019-07-11
Authorized Official Name MR. DAVID LEON AVERY (CHIEF EXECUTIVE OFFICER)
Authorized Official Telephone 6175068188
Authorized Official Credential LMHC
Is Organization Subpart Y
Parent Organization Name COMMONWEALTH MENTAL HEALTH & WELLNESS CENTER

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 251S00000X Community/Behavioral Health Agencies

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1548533789 Commonwealth Mental Health & Wellness Center Community/Behavioral Health 35 Burt St, Dorchester, MA 02124-3705 2012-02-20

Other Data Sources

Entity Type Entity Name Entity Address
Massachusetts Corporations COMMONWEALTH MENTAL HEALTH & WELLNESS CENTER, INC. 895 Blue Hill Avenue, Dorchester, MA 02124

Office Location

Street Address 895 BLUE HILL AVE STE 1
City DORCHESTER
State MA
Zip Code 02124-2902

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NPI Name Taxonomy Address Enumeration
1679109599 Yolanda Barner Behavioral Analyst 241 Norfolk St, Dorchester, MA 02124 2020-03-23
1144878489 Marissa Sneed Case Manager/Care Coordinator 1059 Tremont St Suit 2, Roxbury Crossing, ME 02124 2019-08-29
1407413487 Adrian Velasquez Md LLC Internal Medicine 2110 Dorchester Ave Ste 205, Seton Building, Dorchester, MA 02124 2019-05-24
1164908794 Genesis 365 Care LLC Home Health Aide 114 Fuller St # 1, Dorchester, MA 02124 2018-07-17
1821581422 Prince Nwaford Psychologist 176 Harvard Street, 2, Boston, MA 02124 2018-06-08
1073026753 Massachusetts Chiropractic Center LLC Chiropractor 879-881 Blue Hill Avenue, Dorchester, MA 02124 2017-11-16
1770096620 Aly Tran Behavior Technician 232 Centre St, Dorchester, MA 02124 2017-11-14
1326564386 Mildred R Gomez Community Health Worker 108 Norfolk St, Dorchester, MA 02124 2017-08-21
1871025585 Dwight Dorcy Assistant Behavior Analyst 7 Samoset St # 3, Dorchester, MA 02124 2017-03-31
1346793452 Jennie Lee Nurse Practitioner 425 Harvard St, Dorchester, MA 02124 2016-07-26
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Taxonomy Information

Taxonomy Code 251S00000X
Grouping Agencies
Classification Community/Behavioral Health

Taxonomy Definition

A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1366990533 Till Inc Community/Behavioral Health 78 King St, Dorchester, MA 02122-2438 2016-09-16
1376090613 Joel Berger Community/Behavioral Health 1100 Washington St Ste 206, Dorchester, MA 02124-5520 2016-09-03
1164806295 Bay Cove Human Resources Community/Behavioral Health 863 Adams St, Dorchester, MA 02124 2015-07-18
1578903225 Fyness Inc. Community/Behavioral Health 14b Trull St Apt 2, Dorchester, MA 02125-2186 2013-06-26
1972817096 Familias Para El Progresso Y Cambio Community/Behavioral Health 54 Ruthven St, Dorchester, MA 02121-1611 2010-07-30
1932431673 Dimock Community Health Center Community/Behavioral Health 25 Glenarm Street, Dorchester, MA 02121 2010-02-05
1386814283 Eric Johnson Community/Behavioral Health 18 Harlow St, Dorchester, MA 02125-2614 2008-03-06
1649317595 Bay Cove Human Services, Inc Community/Behavioral Health 105 Victory Rd, Dorchester, MA 02122-3518 2007-01-31
1013549310 Jenna R Morgan Community/Behavioral Health 415 Neponset Ave Ste 3, Dorchester, MA 02122-3169 2020-02-05
1447713474 Strive2beinc Community/Behavioral Health 40 Crestwood Park, Dorchester, MA 02121-1106 2019-04-08
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Competitor

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City DORCHESTER
Zip Code 02124

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Dataset Information

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.

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