| Dimock Community Services Corp. | |
|
45 Dimock St Roxbury MA 02119-1208 | |
| (617) 442-8800 | |
| Not Available |
| Full Name | Dimock Community Services Corp. |
|---|---|
| Speciality | Clinic/Center |
| Location | 45 Dimock St, Roxbury, Massachusetts |
| Authorized Official Name and Position | Junior Luis Rivera (CFO) |
| Authorized Official Contact | 6174428800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dimock Community Services Corp. 55 Dimock Street Roxbury MA 02119 Ph: (617) 442-8800 | Dimock Community Services Corp. 45 Dimock St Roxbury MA 02119-1208 Ph: (617) 442-8800 |
| NPI Number | 1326193269 |
|---|---|
| Provider Enumeration Date | 01/23/2007 |
| Last Update Date | 08/07/2025 |
| Certification Date | 08/07/2025 |
| Medicare PECOS PAC ID | 4385677038 |
|---|---|
| Medicare Enrollment ID | O20050914000391 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326193269 | NPI | - | NPPES |
| 1301241 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (Massachusetts) | Primary |
| Provider Name | Kimberly Rawlins |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689761421 PECOS PAC ID: 4880605617 Enrollment ID: I20060509000130 |
| Provider Name | Chitra Malur |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457493702 PECOS PAC ID: 5092723627 Enrollment ID: I20130124000039 |
| Provider Name | Kira Armajani |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326395435 PECOS PAC ID: 8921328667 Enrollment ID: I20150521000390 |
| Provider Name | Joanna Katsos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255705661 PECOS PAC ID: 1557696333 Enrollment ID: I20190716002995 |
| Provider Name | Rachel Shotkin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760996821 PECOS PAC ID: 7618206426 Enrollment ID: I20190904000718 |
| Provider Name | Jacqueline Fickes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518340785 PECOS PAC ID: 3274864657 Enrollment ID: I20191016001941 |
| Provider Name | Grace Dorothy Bouton |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1417506684 PECOS PAC ID: 1254765449 Enrollment ID: I20191220001869 |
| Provider Name | Elaine Lebel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770121634 PECOS PAC ID: 3678982303 Enrollment ID: I20210511000776 |
| Provider Name | Claralys Gonzalez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922715788 PECOS PAC ID: 6406224328 Enrollment ID: I20221128001969 |
| Provider Name | Ankita Jain |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1053845412 PECOS PAC ID: 1355724543 Enrollment ID: I20230327001912 |
| Provider Name | Amanda Blomberg-faura |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659707305 PECOS PAC ID: 9638521842 Enrollment ID: I20240123002662 |
| Provider Name | Francisco Eduardo Fantes |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1184923922 PECOS PAC ID: 3971049743 Enrollment ID: I20240729003173 |
| Provider Name | Ana Santana Ogando |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770036501 PECOS PAC ID: 2860928785 Enrollment ID: I20241216000448 |
| Provider Name | Ashley Liriano Benjamin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699405308 PECOS PAC ID: 6103355730 Enrollment ID: I20250128002952 |
| Provider Name | Vijaiy Medy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699661777 PECOS PAC ID: 9638679483 Enrollment ID: I20250826000307 |
| Provider Name | Douglas Daniel Skyers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457946907 PECOS PAC ID: 3577067529 Enrollment ID: I20250922001703 |
| Provider Name | Hannah Mendygral |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447971833 PECOS PAC ID: 6406348077 Enrollment ID: I20251120004375 |
| Provider Name | Rucha Joshi |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568198208 PECOS PAC ID: 7214414168 Enrollment ID: I20260122000417 |
| Provider Name | Mary Simpson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679443451 PECOS PAC ID: 3577043538 Enrollment ID: I20260218000481 |
| Provider Name | Pevel Jordan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215795489 PECOS PAC ID: 4183109614 Enrollment ID: I20260401002317 |
Children's Services of Roxbury, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 520 Dudley St, Roxbury, MA 02119 Phone: 617-276-4200 |
Hope House Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8 Farnham St, Roxbury, MA 02119 Phone: 617-971-9360 Fax: 617-971-9366 |
Children's Services of Roxbury, Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 520 Dudley St, Roxbury, MA 02119 Phone: 617-445-6655 Fax: 617-445-0940 |
Dimock Early Intervention Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1800 Columbus Ave, Roxbury, MA 02119 Phone: 617-442-8800 Fax: 617-445-0091 |
Community Caring Clinic LLC Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 55 Warren St, Roxbury, MA 02119 Phone: 617-858-7880 |
The Osiris Group Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 184 Dudley St, Suite 107ll, Roxbury, MA 02119 Phone: 617-442-2002 Fax: 617-442-4002 |