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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 251S00000X | Community/Behavioral Health | Agencies |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548533789 | Commonwealth Mental Health & Wellness Center | Community/Behavioral Health | 35 Burt St, Dorchester, MA 02124-3705 | 2012-02-20 |
Entity Type | Entity Name | Entity Address |
---|---|---|
Massachusetts Corporations | COMMONWEALTH MENTAL HEALTH & WELLNESS CENTER, INC. | 895 Blue Hill Avenue, Dorchester, MA 02124 |
Street Address |
895 BLUE HILL AVE STE 1 |
City | DORCHESTER |
State | MA |
Zip Code | 02124-2902 |
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 |
Find all providers in zip 02124 |
Taxonomy Code | 251S00000X |
Grouping | Agencies |
Classification | Community/Behavioral Health |
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] |
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 |
Find all providers in DORCHESTER |
City | DORCHESTER |
Zip Code | 02124 |
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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.