| Edinburg Center Inc | |
|
205 Burlington Rd Bedford MA 01730-1406 | |
| (781) 761-5208 | |
| (781) 275-7205 |
| Full Name | Edinburg Center Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 205 Burlington Rd, Bedford, Massachusetts |
| Authorized Official Name and Position | Marina Kagan (BILLING MANAGER) |
| Authorized Official Contact | 7817615208 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Edinburg Center Inc 205 Burlington Rd Bedford MA 01730-1406 Ph: (781) 761-5064 | Edinburg Center Inc 205 Burlington Rd Bedford MA 01730-1406 Ph: (781) 761-5208 |
| NPI Number | 1073617353 |
|---|---|
| Provider Enumeration Date | 09/08/2006 |
| Last Update Date | 06/29/2022 |
| Certification Date | 06/29/2022 |
| Medicare PECOS PAC ID | 4486681087 |
|---|---|
| Medicare Enrollment ID | O20060503000404 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073617353 | NPI | - | NPPES |
| 1303287 | Other | MA | MBHP |
| 1303237 | Other | MA | MBHP |
| 1304267 | Medicaid | MA | |
| 1303287 | Medicaid | MA | |
| 1304267 | Other | MA | MBHP |
| M18633 | Other | MA | BCBS |
| Provider Name | Madeline Albert |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326121666 PECOS PAC ID: 2860431566 Enrollment ID: I20050502001291 |
| Provider Name | Miriam C Goodman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932282266 PECOS PAC ID: 0547209140 Enrollment ID: I20050503000069 |
| Provider Name | Joan D Pic |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144395740 PECOS PAC ID: 6103843628 Enrollment ID: I20051024001124 |
| Provider Name | Debra L Spitz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245313568 PECOS PAC ID: 9032136411 Enrollment ID: I20051025000604 |
| Provider Name | Syed A. Jafery |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255582698 PECOS PAC ID: 5890966857 Enrollment ID: I20110922000619 |
| Provider Name | Jill M Harrison |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518192293 PECOS PAC ID: 9739314774 Enrollment ID: I20170127001343 |
| Provider Name | Vicki Leigh Kellam |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972686202 PECOS PAC ID: 5698048619 Enrollment ID: I20170913001039 |
| Provider Name | Anne B Bellefeuille |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851412209 PECOS PAC ID: 7618231424 Enrollment ID: I20180502002682 |
| Provider Name | Fong Y Chan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336479914 PECOS PAC ID: 9032452693 Enrollment ID: I20190522001697 |
| Provider Name | Kimberly A Anderson |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1316599400 PECOS PAC ID: 7618382011 Enrollment ID: I20210217001478 |
| Provider Name | Dorcas Oyebisi Adeniyi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407545700 PECOS PAC ID: 8224483508 Enrollment ID: I20231005002113 |
| Provider Name | Nicholas Ryan Decourcey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609400332 PECOS PAC ID: 3476902685 Enrollment ID: I20231213003279 |
| Provider Name | Bengisu Yanmaz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659911659 PECOS PAC ID: 0648615997 Enrollment ID: I20240227002119 |
| Provider Name | Kaitlynn M Barbour |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780962183 PECOS PAC ID: 7214372481 Enrollment ID: I20240227003163 |
| Provider Name | Charles F Morse |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982726170 PECOS PAC ID: 3476998584 Enrollment ID: I20240228003700 |
| Provider Name | Tali L Rojem |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235417080 PECOS PAC ID: 9133564792 Enrollment ID: I20240305002595 |
| Provider Name | Catherine C Pouche |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700589793 PECOS PAC ID: 2062859036 Enrollment ID: I20240326002772 |
| Provider Name | Pamela S Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285795245 PECOS PAC ID: 7517976574 Enrollment ID: I20240409001531 |
| Provider Name | Cortney M Kerstein |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467697227 PECOS PAC ID: 4385082379 Enrollment ID: I20240410001325 |
| Provider Name | Kaelin M Farmer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295282614 PECOS PAC ID: 1052854627 Enrollment ID: I20240624004152 |
| Provider Name | Hugo A Dominguez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295385953 PECOS PAC ID: 4981133360 Enrollment ID: I20250130000882 |
| Provider Name | Brendan L Mckenna |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205570082 PECOS PAC ID: 7719407923 Enrollment ID: I20250218003212 |
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