MINDCARE AGENCY PC (NPI# 1730557018) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1730557018 |
Entity Type | Organization |
Organization Name | MINDCARE AGENCY PC |
Practice Address |
125 Liberty St Suite 205 Springfield MA 01103-1114 |
Practice Telephone | 4132717136 |
Practice Fax Number | 4132717137 |
Mailing Telephone | 4132717136 |
Mailing Fax Number | 4132717137 |
Enumeration Date | 2015-09-03 |
Last Update Date | 2019-11-18 |
Authorized Official Name | OMAR FARUK (CEO) |
Authorized Official Telephone | 4132717136 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 251S00000X | Community/Behavioral Health | Agencies | ||
N | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities | ||
Y | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
223674 | MA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MA | STATE LICENSE NUMBER | 223674 | 01 |
Street Address |
125 LIBERTY ST SUITE 205 |
City | SPRINGFIELD |
State | MA |
Zip Code | 01103-1114 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619977402 | Peter T Demos | Dermatology | 125 Liberty St, Springfield, MA 01103-2961 | 2005-07-22 |
1881206241 | Carl Amyas Taylor | Counselor | 125 Liberty St, Springfield, MA 01103-1114 | 2020-08-18 |
1346892437 | L&l Life Enrichment Center LLC | Psychologist | 125 Liberty St, Springfield, MA 01103-1114 | 2019-07-10 |
1912440892 | Metrocare of Springfield | Nursing Care | 125 Liberty St, Suite 404, Springfield, MA 01103-1114 | 2016-11-28 |
1730622614 | Metrocare of Springfield | Custodial Care Facility | 125 Liberty St, Springfield, MA 01103-1114 | 2016-11-28 |
1215384409 | Adult and Geriatric Medicine Partners, L.L.C. | Family Medicine | 125 Liberty St, Suite 403, Springfield, MA 01103-1114 | 2016-05-18 |
1457717795 | Metrocare of Springfield LLC | In Home Supportive Care | 125 Liberty St, Suite 404, Springfield, MA 01103-1109 | 2015-12-31 |
1457729741 | Right Choice Health Group LLC | Clinic/Center | 125 Liberty St, Suite 205, Springfield, MA 01103-1114 | 2015-09-03 |
1427431402 | Nicole Dacampo | Registered Nurse | 125 Liberty St, Suite 205, Springfield, MA 01103-1114 | 2015-07-08 |
1427435262 | Nancie Moran | Nurse Practitioner | 125 Liberty St, Suite 403, Springfield, MA 01103-1114 | 2015-04-30 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336790609 | Mahmoud Al Homsi | Dentist | 41 Taylor St. 4th Fl, Springfield, MA 01103 | 2019-09-26 |
1427521749 | Pedro Cruz | Student in an Organized Health Care Education/Training Program | 95 Frank B Murray, Springfield, MA 01103 | 2019-01-09 |
1003325010 | Amber Lynn Chisholm | Counselor | 130 Maple St., Springfield, MA 01103 | 2017-09-21 |
1750737391 | Mande' Counseling | Community/Behavioral Health | 1365 Main St Suite 401, Springfield, MA 01103 | 2016-05-13 |
1528467248 | Amanda M Galloway | Physician Assistant | 1038-1050 Main St, Springfield, MA 01103 | 2014-08-19 |
1114326113 | Anne Marie Belinda | Nurse Practitioner | 1049 Main St., Springfield, MA 01103 | 2014-08-15 |
1538575295 | Sunrise Behavioral Health Clinic, LLC | Clinic/Center | 95 Frank B. Murray Street, Springfield, MA 01103 | 2014-07-02 |
1548675093 | Jessica Lynn Pasalacqua | Dietitian, Registered | 870 Main St., Springfield, MA 01103 | 2014-06-24 |
1003220443 | Ivan Rosario | Counselor | 1695 Main St Ste400, Springfield, MA 01103 | 2014-06-13 |
1275964769 | Leeandrew Rick Wilson | Counselor | 1695 Main St., Springfield, MA 01103 | 2013-12-09 |
Find all providers in zip 01103 |
Taxonomy Code | 2084A0401X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Addiction Medicine |
A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |
Notes: Source: American Osteopathic Board of Neurology and Psychiatry, 2007 [1/1/2008: definition added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851497028 | Susan Cary | Psychiatry & Neurology | 80 Congress St, Springfield, MA 01104-3564 | 2006-09-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467095810 | Siere Jennifer Alkee | Psychiatry & Neurology | 68 N.front St, New Bedford, MA 02740 | 2019-10-17 |
1881015337 | Norton Health Care PC | Psychiatry & Neurology | 85 E Main St Ste A, Norton, MA 02766-2307 | 2014-01-01 |
1104185586 | Adam Bied | Psychiatry & Neurology | 339 Massachusetts Ave, Arlington, MA 02474-6718 | 2012-05-07 |
1598809287 | Nestore J D'angelo | Psychiatry & Neurology | 18 Woodholm Rd, Manchester, MA 01944-1042 | 2007-02-16 |
1245392513 | Roger N Chabra | Psychiatry & Neurology | 284 Starboard Ln, Osterville, MA 02655-1451 | 2006-12-14 |
1487754974 | Amjad Bahnassi | Psychiatry & Neurology | 435 Shrewsbury St Ste 1, Worcester, MA 01604-1691 | 2006-09-24 |
1205934924 | Boston Psychiatry Group, Inc. | Psychiatry & Neurology | 20 Hope Ave Ste G05, Waltham, MA 02453-2781 | 2006-09-20 |
1265446157 | Elliott Gerald Segal | Psychiatry & Neurology | 126b Sewall Ave, Brookline, MA 02446-5327 | 2006-07-28 |
1043239270 | Alan Fisch | Psychiatry & Neurology | 872 Massachusetts Ave., Ste. 2-2, 2-7, Cambridge, MA 02139 | 2006-07-19 |
1093789083 | Michael Joshua Ostacher | Psychiatry & Neurology | 50 Staniford St Ste 580, Massachusetts General Hospital, Boston, MA 02114-2540 | 2006-02-15 |
Find all providers with the same taxonomy |
City | SPRINGFIELD |
Zip Code | 01103 |
Please comment or provide details below to improve the information on MINDCARE AGENCY PC.
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.