| Duxbury Counseling Services | |
|
151 Mystic Ave Suite Six Medford MA 02155-4632 | |
| (781) 396-1199 | |
| (781) 396-1439 |
| Full Name | Duxbury Counseling Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 151 Mystic Ave, Medford, Massachusetts |
| Authorized Official Name and Position | Jane Hill (PRESIDENT) |
| Authorized Official Contact | 7817997055 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Duxbury Counseling Services 151 Mystic Ave Suite Six Medford MA 02155-4632 Ph: (781) 396-1199 | Duxbury Counseling Services 151 Mystic Ave Suite Six Medford MA 02155-4632 Ph: (781) 396-1199 |
| NPI Number | 1215912894 |
|---|---|
| Provider Enumeration Date | 12/07/2005 |
| Last Update Date | 07/10/2007 |
| Medicare PECOS PAC ID | 8820992456 |
|---|---|
| Medicare Enrollment ID | O20031201000715 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215912894 | NPI | - | NPPES |
| 1300512 | Medicaid | MA | |
| M18394 | Other | MA | BCBS |
| Provider Name | Ernst Manigat |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386701688 PECOS PAC ID: 6002729142 Enrollment ID: I20031106000130 |
| Provider Name | Lenore H Pollen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851474282 PECOS PAC ID: 5597736017 Enrollment ID: I20040805001169 |
| Provider Name | Donna M St John |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356482376 PECOS PAC ID: 3072544931 Enrollment ID: I20050830000908 |
| Provider Name | Deborah Max Reisman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841397825 PECOS PAC ID: 6002849395 Enrollment ID: I20050916000412 |
| Provider Name | Mary T Wisniewski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841361789 PECOS PAC ID: 2860427085 Enrollment ID: I20050927000865 |
| Provider Name | Emily B Case |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225148752 PECOS PAC ID: 0941226583 Enrollment ID: I20051021000807 |
| Provider Name | Sharon L Britt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578607859 PECOS PAC ID: 2466473178 Enrollment ID: I20051209000170 |
| Provider Name | Michael Maliszewski |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679500177 PECOS PAC ID: 2062429681 Enrollment ID: I20060307000491 |
| Provider Name | Ann E Carpenter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700083649 PECOS PAC ID: 9830252220 Enrollment ID: I20090401000226 |
| Provider Name | Karen W. Nolen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902046030 PECOS PAC ID: 7214085372 Enrollment ID: I20090429000034 |
| Provider Name | Sandra Ann Theodor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891911749 PECOS PAC ID: 7315128170 Enrollment ID: I20110228000056 |
| Provider Name | Geoffrey L Whitley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083994404 PECOS PAC ID: 4587836408 Enrollment ID: I20111018000574 |
| Provider Name | Timothy A Mckenzie |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760598205 PECOS PAC ID: 0244497725 Enrollment ID: I20120210000809 |
| Provider Name | Janis Monat |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609981109 PECOS PAC ID: 2264694454 Enrollment ID: I20120504000311 |
| Provider Name | Berni Zisserson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992015846 PECOS PAC ID: 8325200413 Enrollment ID: I20120508000004 |
| Provider Name | Christine M Cannon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750602785 PECOS PAC ID: 8022271295 Enrollment ID: I20120525000384 |
| Provider Name | Sonya Garba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902166697 PECOS PAC ID: 7416106430 Enrollment ID: I20121009000016 |
| Provider Name | Stephen C Nadel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831359850 PECOS PAC ID: 2961653266 Enrollment ID: I20121114000554 |
| Provider Name | Lucita C Clondas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396016788 PECOS PAC ID: 3274785522 Enrollment ID: I20121212000426 |
| Provider Name | Amanda Jeanna Fata |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164755427 PECOS PAC ID: 3971829219 Enrollment ID: I20171220001472 |
| Provider Name | Allison J Puliafico |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093167967 PECOS PAC ID: 7012270556 Enrollment ID: I20180413001463 |
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