| Devens Treatment & Recovery Center, Llc | |
|
85 Patton Rd Devens MA 01434-4401 | |
| (978) 615-5200 | |
| Not Available |
| Full Name | Devens Treatment & Recovery Center, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 85 Patton Rd, Devens, Massachusetts |
| Authorized Official Name and Position | Michael P Krupa (CEO) |
| Authorized Official Contact | 9786155200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Devens Treatment & Recovery Center, Llc 85 Patton Rd Devens MA 01434-4401 Ph: () - | Devens Treatment & Recovery Center, Llc 85 Patton Rd Devens MA 01434-4401 Ph: (978) 615-5200 |
| NPI Number | 1811473267 |
|---|---|
| Provider Enumeration Date | 07/18/2018 |
| Last Update Date | 07/18/2018 |
| Medicare PECOS PAC ID | 8123319498 |
|---|---|
| Medicare Enrollment ID | O20181004001566 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811473267 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Secondary |
| Provider Name | Joanna E Poluha Oneil |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235113481 PECOS PAC ID: 3072569847 Enrollment ID: I20050324000374 |
| Provider Name | David E Sorenson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740248210 PECOS PAC ID: 4082661210 Enrollment ID: I20050331000285 |
| Provider Name | Nancy P. Patricia Lange |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1053301937 PECOS PAC ID: 6709822018 Enrollment ID: I20050707000860 |
| Provider Name | Kenneth A Hetzler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083729966 PECOS PAC ID: 6103842778 Enrollment ID: I20051022000095 |
| Provider Name | Fida Hassan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235246802 PECOS PAC ID: 1759351869 Enrollment ID: I20071029000562 |
| Provider Name | Hung K Do |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013069962 PECOS PAC ID: 2860578846 Enrollment ID: I20080401000279 |
| Provider Name | Negar Beheshti |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225295207 PECOS PAC ID: 1355400318 Enrollment ID: I20081105000325 |
| Provider Name | Kathryn R Baldor |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1689742074 PECOS PAC ID: 4789849068 Enrollment ID: I20120712000188 |
| Provider Name | Erin Rauscher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629271119 PECOS PAC ID: 5799729067 Enrollment ID: I20140430002451 |
| Provider Name | Adam C Lau |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649415530 PECOS PAC ID: 0143408914 Enrollment ID: I20151119001762 |
| Provider Name | Pauline Temu Eteng |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487026399 PECOS PAC ID: 3779880570 Enrollment ID: I20160322001724 |
| Provider Name | Colin B. White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487012282 PECOS PAC ID: 7012297609 Enrollment ID: I20161219001116 |
| Provider Name | Jarrod A Marks |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750731949 PECOS PAC ID: 6103162870 Enrollment ID: I20190117000437 |
| Provider Name | Kristin Anna Mikkelsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225384951 PECOS PAC ID: 1658520762 Enrollment ID: I20190318000855 |
| Provider Name | Annet Nakku Mukasa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972004182 PECOS PAC ID: 9638410103 Enrollment ID: I20190410000739 |
| Provider Name | Susan V Eagleson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366853251 PECOS PAC ID: 8729369244 Enrollment ID: I20190801000927 |
| Provider Name | Isha R. Jalnapurkar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235539149 PECOS PAC ID: 0840563888 Enrollment ID: I20190807002289 |
| Provider Name | Valerie Rice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457800997 PECOS PAC ID: 0042575920 Enrollment ID: I20200318000177 |
| Provider Name | David C Freeman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124480355 PECOS PAC ID: 2163713082 Enrollment ID: I20200526003089 |
| Provider Name | Jean-merimee N Kouagheu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689208050 PECOS PAC ID: 3577982198 Enrollment ID: I20201001001074 |
| Provider Name | Alison Elizabeth Ballantyne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336693951 PECOS PAC ID: 6103245444 Enrollment ID: I20201006000862 |
| Provider Name | Allison W. Beckler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265726558 PECOS PAC ID: 4183921984 Enrollment ID: I20201013000940 |
| Provider Name | Kristen A Hickey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194851212 PECOS PAC ID: 0547672636 Enrollment ID: I20201214002975 |
| Provider Name | Abdonne Ngo Nyele Mbouadeu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184221046 PECOS PAC ID: 4284046160 Enrollment ID: I20201217001593 |
| Provider Name | Kristen Cahill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003027574 PECOS PAC ID: 9335551167 Enrollment ID: I20201218001010 |
| Provider Name | Jean Daniel Mesquita Mello |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053763730 PECOS PAC ID: 0345671467 Enrollment ID: I20210128003164 |
| Provider Name | Roger John Martinkus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184251464 PECOS PAC ID: 0345659165 Enrollment ID: I20210507001350 |
| Provider Name | Margarida Botelho |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699443150 PECOS PAC ID: 4587054069 Enrollment ID: I20211124002268 |
| Provider Name | Jennifer Ramirez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982333761 PECOS PAC ID: 1557745296 Enrollment ID: I20220830003380 |
| Provider Name | Raymond Odiaka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275135584 PECOS PAC ID: 5092126391 Enrollment ID: I20230228000483 |
| Provider Name | Omar A. Shah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285043778 PECOS PAC ID: 6103242011 Enrollment ID: I20230508001804 |
| Provider Name | Jannet Li Harkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962010272 PECOS PAC ID: 9931511078 Enrollment ID: I20230626001050 |
| Provider Name | Alberta K Adu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528722451 PECOS PAC ID: 8628432192 Enrollment ID: I20230918000100 |
| Provider Name | Hanane Taha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972068591 PECOS PAC ID: 3779936836 Enrollment ID: I20240125001859 |
| Provider Name | Therese Pelagie Bonok |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467149765 PECOS PAC ID: 5294188033 Enrollment ID: I20240129003139 |
| Provider Name | Mercedes I Tejada |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306623848 PECOS PAC ID: 0547608507 Enrollment ID: I20240410000158 |
| Provider Name | Macrina Chidarikire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154194538 PECOS PAC ID: 9133568504 Enrollment ID: I20240417004326 |
| Provider Name | Stephanie D Grant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790460756 PECOS PAC ID: 6305286246 Enrollment ID: I20240425003012 |
| Provider Name | Robert Kalugo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730878273 PECOS PAC ID: 1355781006 Enrollment ID: I20240430000056 |
| Provider Name | Sophia Khalifa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013794544 PECOS PAC ID: 2062852593 Enrollment ID: I20240501002865 |
| Provider Name | James K Muchiri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750106902 PECOS PAC ID: 5294265492 Enrollment ID: I20250203002884 |
New England Counseling Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 84 Antietam Street, Devens, MA 01434 Phone: 888-224-7312 |