PINE STREET INN (NPI# 1649658741) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649658741 |
| Entity Type | Organization |
| Organization Name | PINE STREET INN |
| Practice Address |
170 Morton St Boston MA 02130-3735 |
| Mailing Address |
1220 Adams St G17 Boston MA 02124-5752 |
| Practice Telephone | 6178927893 |
| Mailing Telephone | 9173342916 |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2015-05-11 |
| Authorized Official Name | MS. MARIA IMELDA FITZPATRICK (CLINICIAN) |
| Authorized Official Telephone | 6178927893 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 276400000X | Rehabilitation, Substance Use Disorder Unit | 220519 | MA | Hospital Units |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679608384 | Pine Street Inn | Community/Behavioral Health | 444 Harrison Ave, Boston, MA 02118-2404 | 2007-02-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | PINE STREET INN HOUSING, INC. | 444 Harrison Ave., Boston, MA 02118 |
| Massachusetts Corporations | PINE STREET INN, INC. | 444 Harrison Ave., Boston, MA 02118 |
| Street Address |
170 MORTON ST |
| City | BOSTON |
| State | MA |
| Zip Code | 02130-3735 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083266936 | Theresa Grace Bulan | Counselor | 170 Morton St, Boston, MA 02130-3735 | 2019-07-11 |
| 1669989778 | Carmen Celeste Thurston | Counselor | 170 Morton St, Boston, MA 02130-3735 | 2018-01-10 |
| 1649780008 | Jennifer Smith | Social Worker | 170 Morton St, Boston, MA 02130-3735 | 2017-10-11 |
| 1679002158 | Sophia Lin | Student in an Organized Health Care Education/Training Program | 170 Morton St, Boston, MA 02130-3735 | 2017-06-08 |
| 1841728631 | Michael Ivan Yuille | Counselor | 170 Morton St, Boston, MA 02130 | 2017-05-24 |
| 1043761588 | Melissa Lee Nilles | Counselor | 170 Morton St, Boston, MA 02130-3735 | 2016-10-19 |
| 1629529342 | Hannah Campbell | Counselor | 170 Morton St, 11n, Boston, MA 02130-3735 | 2016-10-18 |
| 1386197119 | Victoria Wong | Counselor | 170 Morton St, Boston, MA 02130-3735 | 2016-07-28 |
| 1013269638 | Paul G Brewer | Social Worker | 170 Morton St, Boston, MA 02130-3735 | 2012-10-05 |
| 1467763623 | Melbeth Marlang | Physician Assistant | 170 Morton St, Boston, MA 02130-3735 | 2010-06-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952913121 | Virginia Dawn Pratt | Social Worker | Ethos, 555 Amory Street, Jamaica Plain, MA 02130 | 2020-08-19 |
| 1689139917 | Lina Skiba | Speech-Language Pathologist | Thom Child & Family Services, 555 Armory St, Jamaica Plain, MA 02130 | 2019-01-31 |
| 1841775442 | Melissa Rocklen | Social Worker | 30 Germania St Bldg C, Jamaica Plain, MA 02130 | 2018-09-28 |
| 1902389281 | Susan N. Berkman | Social Worker | 111 Perkins St., Apt.120, Jamaica Plain, MA 02130 | 2018-09-12 |
| 1326551912 | Cindy Tromp | Counselor | Arbour Hospital, 49 Robinwood Ave, Jamaica Plain, MA 02130 | 2017-11-06 |
| 1811415128 | Jesse Myles Carmen | Social Worker | 555 Armory Street, Jamaica Plain, MA 02130 | 2017-09-07 |
| 1881119410 | Melanie Suzanne Witman | Counselor | 1125 Centre Street, Boston, MA 02130 | 2017-08-04 |
| 1740702125 | Farah Clermont | Counselor | 3815 Washington St., Jamaica Plain, MA 02130 | 2017-07-07 |
| 1346777554 | Anjalie L Pieres | Counselor | 157 Green Streey, Jamaica Plain, MA 02130 | 2017-05-18 |
| 1316480098 | Caroline Amina Shaw-moss | Counselor | 7 Burr St., Boston, MA 02130 | 2016-11-29 |
| Find all providers in zip 02130 | ||||
| Taxonomy Code | 276400000X |
| Grouping | Hospital Units |
| Classification | Rehabilitation, Substance Use Disorder Unit |
| A distinct part of a hospital that provides medically monitored, interdisciplinary addiction-focused treatment to patients/clients who have psychoactive substance use disorders (commonly referred to as alcohol and drug abuse or substance abuse.) |
| Notes: Source: Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912216375 | Steward St. Elizabeth's Medical Center of Boston, Inc. | Rehabilitation, Substance Use Disorder Unit | 736 Cambridge St, Boston, MA 02135-2907 | 2010-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104469592 | Living In Freedom Together Lift Inc | Rehabilitation, Substance Use Disorder Unit | 40 Mendon St, Worcester, MA 01604-4824 | 2019-10-18 |
| 1316080195 | Christopher Joseph Shaw | Rehabilitation, Substance Use Disorder Unit | 17 Prince Street, Unit 2, Jamaica Plain, MA 02130 | 2007-02-14 |
| 1336688415 | High Point Treatment Center | Rehabilitation, Substance Use Disorder Unit | 10 Meadowbrook Rd, Brockton, MA 02301-7122 | 2017-02-22 |
| 1316165517 | St Annes Hospital | Rehabilitation, Substance Use Disorder Unit | 795 Middle St, Fall River, MA 02721-1733 | 2007-04-23 |
| 1154489615 | Caritas Good Samaritan Medical Center | Rehabilitation, Substance Use Disorder Unit | 71 Walnut St, Foxboro, MA 02035-2533 | 2006-12-05 |
Please comment or provide details below to improve the information on PINE STREET INN.
| 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.