Basic Information
| Provider Information | |||||||||
| NPI: | 1285708776 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NORTH SUFFOLK MENTAL HEALTH ASSOCIATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | 301 BROADWAY | ||||||||
| Address2: | |||||||||
| City: | CHELSEA | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021502807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6178894860 | ||||||||
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| Practice Location | |||||||||
| Address1: | 14 PORTER ST | ||||||||
| Address2: | |||||||||
| City: | EAST BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021282116 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6179127000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2006 | ||||||||
| LastUpdateDate: | 07/10/2008 | ||||||||
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| AuthorizedOfficialLastName: | CURTIS | ||||||||
| AuthorizedOfficialFirstName: | MARTHA | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | CLINICAL MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 6179127519 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | R.N., LICSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | 113521 | MA | Y | Agencies | Community/Behavioral Health |
No ID Information.