ODONATA PSYCHOTHERAPY & RETREAT CENTER LLC (NPI# 1689090862) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689090862 |
| Entity Type | Organization |
| Organization Name | ODONATA PSYCHOTHERAPY & RETREAT CENTER LLC |
| Practice Address |
121 Main St Buzzards Bay MA 02532 |
| Mailing Address |
19 Pine Rd Forestdale MA 02644-1413 |
| Practice Telephone | 7742474939 |
| Mailing Telephone | 7742474939 |
| Mailing Fax Number | 7743024419 |
| Enumeration Date | 2014-03-11 |
| Last Update Date | 2018-08-15 |
| Authorized Official Name | NANCY C WILEY (OWNER) |
| Authorized Official Telephone | 7742474939 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 110101319A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902285414 | Odonata Psychotherapy & Retreat Center LLC | Social Worker | 121 Main St, Buzzards Bay, MA 02532 | 2015-05-29 |
| Street Address |
121 MAIN ST |
| City | BUZZARDS BAY |
| State | MA |
| Zip Code | 02532 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689165300 | Jodi L Stapler | Counselor | 121 Main St, Buzzards Bay, MA 02532-3245 | 2018-05-29 |
| 1033617576 | Kelly Kramer | Social Worker | 121 Main St, Buzzards Bay, MA 02532-3245 | 2018-01-30 |
| 1902285414 | Odonata Psychotherapy & Retreat Center LLC | Social Worker | 121 Main St, Buzzards Bay, MA 02532 | 2015-05-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194380766 | Continuous Motion Physical Therapy | Physical Therapist | 10 Millenium Drive, Bourne, MA 02532 | 2019-05-08 |
| 1023466380 | Margaret Crane | Student in an Organized Health Care Education/Training Program | 25 Presidents Road, Bourne, MA 02532 | 2016-05-27 |
| 1003072588 | Sylvia C Koo | Dentist | 9 County Road, Bourne, MA 02532 | 2008-08-04 |
| 1285833848 | Eye Health Care of Bourne | Ophthalmology | 1 Trowbridge Rd., Suite 333, Bourne, MA 02532 | 2007-07-13 |
| 1235290024 | Dana F Zweig | Family Medicine | 118c Waterhouse Road, Bourne, MA 02532 | 2006-12-13 |
| 1053491779 | Royal Health Group LLC | Skilled Nursing Facility | 8 Lewis Point Road, Buzzards Bay, MA 02532 | 2006-10-17 |
| 1609988328 | Dana Christopher Ricker | Optometrist | 16 Macarthur Blvd, Bourne, MA 02532 | 2006-08-31 |
| 1417922311 | Cheryl A Hitchings | Physician Assistant | 1 Trowbridge Road, Suite 100, Bourne, MA 02532 | 2006-02-22 |
| 1023007283 | Scott M Harris | Specialist | One Trowbridge Road, Bourne, MA 02532 | 2005-10-19 |
| 1063842698 | Alyssa Verronneau | Behavioral Analyst | 134 Main Street, Buzzards Bay, MA 02532 | 2013-11-18 |
| Find all providers in zip 02532 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861971855 | Keith Aaron Townley | Counselor | 258 Main St Ste B4, Buzzards Bay, MA 02532-3251 | 2018-08-09 |
| 1942661897 | Kenneth Smith | Counselor | 26 Cahoon Rd, Apt A, Buzzards Bay, MA 02532-4802 | 2016-03-18 |
| 1497887087 | Dale-ann Cotter | Counselor | 10 Wallace Ave, Buzzards Bay, MA 02532-3239 | 2007-03-10 |
| 1952843229 | Stephanie Stolar | Counselor | 258 Main St, B4, Buzzards Bay, MA 02532-3222 | 2016-11-17 |
| 1912331398 | Caitlyn Terese Watt | Counselor | 9 Saint Margarets St, Buzzards Bay, MA 02532-3269 | 2013-08-21 |
| 1609118280 | Southeast Clinical Collaboration | Counselor | 9 Saint Margarets St, Buzzards Bay, MA 02532-3269 | 2013-03-21 |
| 1578807327 | Sarah Fenton | Counselor | 9 Saint Margarets St, Buzzards Bay, MA 02532-3269 | 2012-11-18 |
| 1649305111 | Linda E Hood-glidden | Counselor | 258 Main St, Suite B-4, Buzzards Bay, MA 02532-3222 | 2007-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811596703 | Courtney Rose Bieda | Counselor | 1340 Washington St Apt 3, Weymouth, MA 02189-2360 | 2020-10-21 |
| 1023617339 | Meghan Earle | Counselor | 1354 Hancock St Ste 214, Quincy, MA 02169-5109 | 2020-10-19 |
| 1104425420 | Mindful Path Therapy LLC | Counselor | 163 Highland Ave # 1057, Needham, MA 02494-3025 | 2020-10-19 |
| 1184222531 | Antoinett Gomes | Counselor | 11 Battles St Apt 3, Brockton, MA 02301-2236 | 2020-10-16 |
| 1710585252 | Andrada Mihaila | Counselor | 120 Maple St Ste 301, Springfield, MA 01103-2216 | 2020-10-16 |
| 1780282335 | Susan Warren | Counselor | Martha's Vineyard Community Services, 111 Edgartown Rd, Oak Bluffs, MA 02557 | 2020-10-15 |
| 1831797646 | Paula Arrigg | Counselor | 175 Dwight Road, Longmeadow, MA 01106 | 2020-10-14 |
| 1790383693 | Bowlight Partners LLC | Counselor | 32 Edgewood Rd, Lexington, MA 02420-3500 | 2020-10-13 |
| 1316545510 | Leonard Paul Dagesse | Counselor | 51 Gladstone St, Brockton, MA 02302-3338 | 2020-10-12 |
| 1659979847 | Melina Canter | Counselor | 581 Pleasant St Apt 2r, Holyoke, MA 01040-2368 | 2020-10-12 |
| Find all providers with the same taxonomy | ||||
| City | BUZZARDS BAY |
| Zip Code | 02532 |
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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.