EVELYN DOUGHERTY (NPI# 1861539629) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861539629 |
| Entity Type | Individual |
| Full Name | EVELYN DOUGHERTY |
| Credential | LICSW |
| Practice Address |
45 Dimock St Roxbury MA 02119-1208 |
| Mailing Address |
Po Box 300415 Jamaica Plain MA 02130-0004 |
| Practice Telephone | 6174428800 |
| Mailing Telephone | 6174428800 |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2020-02-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
107476 | MA | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 56 Dimock St, Roxbury, MA 021191210 | 6174428800 |
| Street Address |
45 DIMOCK ST |
| City | ROXBURY |
| State | MA |
| Zip Code | 02119-1208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104813856 | Debra Jean Reid | Pharmacist | 45 Dimock St, Roxbury, MA 02119-1208 | 2005-09-27 |
| 1063022028 | Hoda Hamed | Optometrist | 45 Dimock St, Roxbury, MA 02119-1208 | 2020-08-05 |
| 1790394096 | Jonathan Foster-moore | Nurse Practitioner | 45 Dimock St, Roxbury, MA 02119-1208 | 2020-07-23 |
| 1730797077 | Kristie Michelle Grimes-mallard | Registered Nurse | 45 Dimock St, Roxbury, MA 02119-1208 | 2020-07-22 |
| 1558987859 | Dina Cabrejos Arauco | Social Worker | 45 Dimock St, Roxbury, MA 02119-1208 | 2020-06-23 |
| 1104440908 | Joelle Sulistio | Registered Nurse | 45 Dimock St, Roxbury, MA 02119-1208 | 2020-06-08 |
| 1346883980 | Kristen Monique Beard | Registered Nurse | 45 Dimock St, Roxbury, MA 02119-1208 | 2019-10-27 |
| 1639731649 | Alyssa Meltzer | Social Worker | 45 Dimock St, Roxbury, MA 02119-1208 | 2019-07-01 |
| 1184283012 | Claudia Rizzo | Social Worker | 45 Dimock St, Roxbury, MA 02119-1208 | 2019-06-13 |
| 1740849959 | Sabiha Zaman | Social Worker | 45 Dimock St, Roxbury, MA 02119-1208 | 2019-06-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427661644 | Christina Kim Hunt | Case Manager/Care Coordinator | 75 Amory St, Garden Level, Boston, MA 02119 | 2020-08-27 |
| 1962021089 | Taha Fathima Khan | Student in an Organized Health Care Education/Training Program | Boston Medical Center, 801 Albany Street, 3rd Floor, Department of Pediatrics, Boston, MA 02119 | 2020-04-09 |
| 1154957132 | Katherine Erin Douglas | Pediatrics | 801 Albany Street, 3rd Floor, Department of Pediatrics, Boston, MA 02119 | 2020-03-21 |
| 1720536568 | Ramy Y Barrett | Counselor | 77 Savin Street, Apartment # 3, Boston, MA 02119 | 2016-09-21 |
| 1083089676 | Natasha Cruz | Counselor | 263 Eustis Street, Roxbury, MA 02119 | 2015-12-08 |
| 1922478486 | Natalie Jones | Counselor | 520 Dudley St., Roxbury, MA 02119 | 2015-09-28 |
| 1922484799 | Dina Ghaly-habib | Student in an Organized Health Care Education/Training Program | 100 East Newton St., G-706, Boston, MA 02119 | 2015-08-04 |
| 1942697248 | Pyramid Builders | Case Management | 11 Roxbury Street, Boston, MA 02119 | 2015-04-24 |
| 1063810984 | Sophia Smalls | Counselor | 250 Walnut Ave, Apt. 10, Boston, MA 02119 | 2014-12-09 |
| 1750705059 | Alasa Hawkins | Counselor | 502 Dudley St, Roxbury, MA 02119 | 2014-02-07 |
| Find all providers in zip 02119 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104320357 | Juan Grullon | Counselor | 302 Eustis St, Roxbury, MA 02119-3800 | 2018-03-22 |
| 1083089676 | Natasha Cruz | Counselor | 263 Eustis Street, Roxbury, MA 02119 | 2015-12-08 |
| 1083046205 | Christopher Conway | Counselor | 432 Dudley St Ste 211, Roxbury, MA 02119-2763 | 2013-07-30 |
| 1215297304 | Earl Dandy Jr. | Counselor | 15 Elmore St # 2, Roxbury, MA 02119-1618 | 2012-05-22 |
| 1437385754 | Alice Wood Griffin | Counselor | 28 Hemlock Rd, Roxbury, CT 06783-1409 | 2009-06-01 |
| 1861612053 | Ameatriss Little | Counselor | 55 Topeka Street, Roxbury, MA 02215 | 2007-04-27 |
| 1184128050 | Anna M Rodriguez | Counselor | 302 Eustis St, Roxbury, MA 02119-3800 | 2018-03-23 |
| 1104320365 | Mary-alyssa E Nieman | Counselor | 302 Eustis St, Roxbury, MA 02119-3800 | 2018-03-22 |
| 1881198034 | Jose O Colon | Counselor | 245 Eustis St, Roxbury, MA 02119-2826 | 2018-03-22 |
| 1922502186 | Dina Park-matsas | Counselor | 302 Eustis St, Roxbury, MA 02119-3800 | 2018-03-22 |
| Find all providers in ROXBURY | ||||
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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.