| Colony Care Behavioral Health | |
|
11 River St Wellesley MA 02481-2098 | |
| (781) 431-1177 | |
| (781) 431-1181 |
| Full Name | Colony Care Behavioral Health |
|---|---|
| Speciality | Counselor |
| Location | 11 River St, Wellesley, Massachusetts |
| Authorized Official Name and Position | Gregory A Serrao (PRESIDENT) |
| Authorized Official Contact | 7814311177 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Colony Care Behavioral Health 11 River St Wellesley MA 02481-2098 Ph: (781) 431-1177 | Colony Care Behavioral Health 11 River St Wellesley MA 02481-2098 Ph: (781) 431-1177 |
| NPI Number | 1720053408 |
|---|---|
| Provider Enumeration Date | 02/17/2006 |
| Last Update Date | 09/20/2023 |
| Certification Date | 09/20/2023 |
| Medicare PECOS PAC ID | 0042282055 |
|---|---|
| Medicare Enrollment ID | O20040810001192 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720053408 | NPI | - | NPPES |
| 42304 | Other | MA | MAGELLAN |
| 732804 | Other | MA | TUFTS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Tracy Barnes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053395616 PECOS PAC ID: 9032189733 Enrollment ID: I20040729000890 |
| Provider Name | Susan P Stevens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487610168 PECOS PAC ID: 7517932528 Enrollment ID: I20040901000476 |
| Provider Name | Mark F Geer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1609843507 PECOS PAC ID: 1951374784 Enrollment ID: I20050314001032 |
| Provider Name | Mahmood Hussain Sharfi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154311611 PECOS PAC ID: 6901823897 Enrollment ID: I20051031000248 |
| Provider Name | Susan M Lyons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477572964 PECOS PAC ID: 6901820067 Enrollment ID: I20060117000720 |
| Provider Name | Daniel S Jaquette |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396712204 PECOS PAC ID: 8022080035 Enrollment ID: I20080521000580 |
| Provider Name | Daniel L Jackson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992874234 PECOS PAC ID: 0446320220 Enrollment ID: I20080605000356 |
| Provider Name | Stacey M Mastromatteo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831421007 PECOS PAC ID: 8820127590 Enrollment ID: I20100519000402 |
| Provider Name | Jessica E Zieky |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679723639 PECOS PAC ID: 4284758772 Enrollment ID: I20100907000406 |
| Provider Name | Ryan M Gazzola |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477760775 PECOS PAC ID: 9335365469 Enrollment ID: I20140728000259 |
| Provider Name | Matthew S Ellam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083006696 PECOS PAC ID: 7012299522 Enrollment ID: I20170118000782 |
| Provider Name | Ashley L Tobey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154705572 PECOS PAC ID: 1850676321 Enrollment ID: I20170323002344 |
| Provider Name | Kelly Sellers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376102319 PECOS PAC ID: 5799012852 Enrollment ID: I20190812003506 |
| Provider Name | Jackie Audi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407417991 PECOS PAC ID: 5698005254 Enrollment ID: I20190924002560 |
| Provider Name | Elysee M Njontu |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1710447651 PECOS PAC ID: 4486985298 Enrollment ID: I20191009001574 |
| Provider Name | Valerie Rice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457800997 PECOS PAC ID: 0042575920 Enrollment ID: I20200318000177 |
| Provider Name | Henry F Lou-goode |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467075614 PECOS PAC ID: 8325468531 Enrollment ID: I20201008002423 |
| Provider Name | David Sugarbaker |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1154934685 PECOS PAC ID: 1951713163 Enrollment ID: I20201211002489 |
| Provider Name | Charles S Mahdy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750978755 PECOS PAC ID: 5890103063 Enrollment ID: I20210428001574 |
| Provider Name | Erica Goroshko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265032874 PECOS PAC ID: 4183033939 Enrollment ID: I20210506001726 |
| Provider Name | Naila Tariq |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649761321 PECOS PAC ID: 9537568613 Enrollment ID: I20210521000519 |
| Provider Name | Alyssa Desroches |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801171285 PECOS PAC ID: 8123429933 Enrollment ID: I20210630004035 |
| Provider Name | Keri Ann Marinelli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396371761 PECOS PAC ID: 7416359377 Enrollment ID: I20210714002874 |
| Provider Name | Nicole Sauve |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770981243 PECOS PAC ID: 6800263435 Enrollment ID: I20221110000855 |
| Provider Name | Kristy Lee Eagles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306042338 PECOS PAC ID: 7517118789 Enrollment ID: I20221122001625 |
| Provider Name | Tatiana Sanabria |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235879149 PECOS PAC ID: 2062881568 Enrollment ID: I20221205002602 |
| Provider Name | Marisa Greaves |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457863672 PECOS PAC ID: 6800255340 Enrollment ID: I20230630003047 |
| Provider Name | Jessica Carole Conaway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841993532 PECOS PAC ID: 1153781547 Enrollment ID: I20230717003103 |
| Provider Name | Despina Prassas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083315261 PECOS PAC ID: 4486016904 Enrollment ID: I20230816000860 |
| Provider Name | Gregory Alan Hard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356916795 PECOS PAC ID: 5395190557 Enrollment ID: I20231009002965 |
| Provider Name | Biping Huang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295512184 PECOS PAC ID: 9133577505 Enrollment ID: I20231122002862 |
| Provider Name | Jamara Lynn Polzin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881304665 PECOS PAC ID: 7911355037 Enrollment ID: I20231130001764 |
| Provider Name | Tara Conklin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023741709 PECOS PAC ID: 9830540129 Enrollment ID: I20240111001128 |
| Provider Name | Jessie Lynn Harper |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740062132 PECOS PAC ID: 6800248998 Enrollment ID: I20240112003980 |
| Provider Name | Kaysie Lynn Elg |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114238102 PECOS PAC ID: 4880046978 Enrollment ID: I20240112004032 |
| Provider Name | Sari Jo Starr |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124043476 PECOS PAC ID: 6103278080 Enrollment ID: I20240116003276 |
| Provider Name | Amber M. Yannizzi |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003362369 PECOS PAC ID: 4981057940 Enrollment ID: I20240126000785 |
| Provider Name | Alexandra Marcelle Lucey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1417406414 PECOS PAC ID: 8729431473 Enrollment ID: I20240129003658 |
Evolve Internal Wellness And Counseling, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 14 Haven Road, Wellesley, MA 02481 Phone: 603-455-2428 Fax: 617-706-2603 | |
Richard H Stellar Edd Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 486 Washington St, Wellesley, MA 02482 Phone: 781-235-6969 Fax: 781-235-6969 | |
The Elliot Lewis Center For Multiple Sclerosis Care Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 Cedar St Ste 110, Wellesley, MA 02481 Phone: 781-591-8300 | |
Kelly Mitchell, Psyd Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 592a Washington St Fl 2, Wellesley, MA 02482 Phone: 508-380-8757 | |
Mark Frankel Md Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 148 Linden St Ste 109, Wellesley, MA 02482 Phone: 917-575-1641 Fax: 781-489-5476 | |
Advanced Neurotherapy, Pc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 140 Bristol Rd, Wellesley, MA 02481 Phone: 781-444-9115 | |
Heather F. Adams, Ph.d., Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Hollis St, Suite 240, Wellesley, MA 02482 Phone: 781-910-7334 |