| Bay Coast Behavioral, Llc | |
|
170 Pleasant St Room 100 Fall River MA 02721-3015 | |
| (774) 294-5722 | |
| (774) 294-5724 |
| Full Name | Bay Coast Behavioral, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 170 Pleasant St, Fall River, Massachusetts |
| Authorized Official Name and Position | Traci Maurie Patch (EXECUTIVE ASSISTANT) |
| Authorized Official Contact | 7742945722 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bay Coast Behavioral, Llc 170 Pleasant St Room 100 Fall River MA 02721-3015 Ph: (774) 294-5722 | Bay Coast Behavioral, Llc 170 Pleasant St Room 100 Fall River MA 02721-3015 Ph: (774) 294-5722 |
| NPI Number | 1184963993 |
|---|---|
| Provider Enumeration Date | 02/14/2013 |
| Last Update Date | 10/24/2023 |
| Certification Date | 10/24/2023 |
| Medicare PECOS PAC ID | 2365888575 |
|---|---|
| Medicare Enrollment ID | O20240311002037 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184963993 | NPI | - | NPPES |
| Provider Name | Lisa Marie Joyce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922546407 PECOS PAC ID: 0749541449 Enrollment ID: I20180220002408 |
| Provider Name | Enoch Anyanwu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730799040 PECOS PAC ID: 7315351020 Enrollment ID: I20210120002192 |
| Provider Name | Lisa A Chapman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265189336 PECOS PAC ID: 1951772862 Enrollment ID: I20230131002512 |
| Provider Name | Olivia Parker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477854479 PECOS PAC ID: 1254777469 Enrollment ID: I20240311002112 |
| Provider Name | Matthew Millman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033728316 PECOS PAC ID: 9931545910 Enrollment ID: I20240313000423 |
| Provider Name | Berina Conceicao Mattos |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942414826 PECOS PAC ID: 0446696652 Enrollment ID: I20240401003285 |
| Provider Name | Amanda Baldaro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003278318 PECOS PAC ID: 0547608986 Enrollment ID: I20240404002847 |
| Provider Name | Hayleigh Dumas |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558823914 PECOS PAC ID: 6901244268 Enrollment ID: I20240404003700 |
| Provider Name | Chelsi Gemba |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679985089 PECOS PAC ID: 9830538636 Enrollment ID: I20240412001835 |
| Provider Name | Geraldei Paul |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609485945 PECOS PAC ID: 5193167070 Enrollment ID: I20240523000804 |
| Provider Name | Renisa Dealvarenga |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104464361 PECOS PAC ID: 2769924547 Enrollment ID: I20240607002271 |
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