| Northeast Behavioral Health Corporation | |
|
800 Cummings Center Suite 266t Beverly MA 01915-6172 | |
| (978) 921-1190 | |
| (978) 927-3724 |
| Full Name | Northeast Behavioral Health Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 800 Cummings Center, Beverly, Massachusetts |
| Authorized Official Name and Position | Hilary Jacobs (PRESIDENT) |
| Authorized Official Contact | 9789681712 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Behavioral Health Corporation 199 Rosewood Dr Ste 250 Danvers MA 01923-1684 Ph: (978) 968-1700 | Northeast Behavioral Health Corporation 800 Cummings Center Suite 266t Beverly MA 01915-6172 Ph: (978) 921-1190 |
| NPI Number | 1154302586 |
|---|---|
| Provider Enumeration Date | 11/11/2005 |
| Last Update Date | 04/19/2022 |
| Certification Date | 04/19/2022 |
| Medicare PECOS PAC ID | 0446155808 |
|---|---|
| Medicare Enrollment ID | O20100817000286 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154302586 | NPI | - | NPPES |
| 106214 | Other | MA | MBC |
| 1001430 | Other | MA | BEACON |
| 62-00062 | Other | MA | EVERCARE-LICSW |
| 15-00109 | Other | MA | EVERCARE-MD |
| 42702 | Other | MA | MBC |
| 61-00068 | Other | MA | EVERCARE -PHD |
| 83-00260 | Other | MA | EVERCARE-RNCS |
| 996119 | Other | NETWORK HEALTH |
| Provider Name | Marcia E Nelson Vancini |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1215127840 PECOS PAC ID: 8527950369 Enrollment ID: I20040326000913 |
| Provider Name | Robert S Henriques |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508847898 PECOS PAC ID: 1254323124 Enrollment ID: I20040331001230 |
| Provider Name | Susan Rudman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992722714 PECOS PAC ID: 3870587728 Enrollment ID: I20040413000876 |
| Provider Name | Courtney H Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801089826 PECOS PAC ID: 5799768164 Enrollment ID: I20040608001138 |
| Provider Name | Altagracia Ramirez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235186925 PECOS PAC ID: 3072598101 Enrollment ID: I20040622001047 |
| Provider Name | Jacob J Venter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063402378 PECOS PAC ID: 6608854922 Enrollment ID: I20040805000271 |
| Provider Name | Katherine K Miura |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801853007 PECOS PAC ID: 2961453584 Enrollment ID: I20050201000595 |
| Provider Name | Sherry E Murray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164543179 PECOS PAC ID: 1658323100 Enrollment ID: I20050214000355 |
| Provider Name | Diana M Sinagra |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386753424 PECOS PAC ID: 3274587324 Enrollment ID: I20050310000905 |
| Provider Name | Mary Anna Sullivan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295759249 PECOS PAC ID: 6608822663 Enrollment ID: I20050323000839 |
| Provider Name | Anthony C Erdmann |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962485748 PECOS PAC ID: 9234178229 Enrollment ID: I20050428000967 |
| Provider Name | Smita K Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619913894 PECOS PAC ID: 4183668932 Enrollment ID: I20050616000182 |
| Provider Name | Lynne M Carlson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093956484 PECOS PAC ID: 0648201350 Enrollment ID: I20050823000322 |
| Provider Name | Alan W Mallas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801984422 PECOS PAC ID: 5294767414 Enrollment ID: I20050908000243 |
| Provider Name | Joan E Longwell |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1568620979 PECOS PAC ID: 7012949183 Enrollment ID: I20050909000252 |
| Provider Name | Amy N Greene |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194907253 PECOS PAC ID: 7315970290 Enrollment ID: I20050912000889 |
| Provider Name | Teresa K. Newkirk Boy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578626818 PECOS PAC ID: 6800812934 Enrollment ID: I20051018001165 |
| Provider Name | Jane T Schwartz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205941358 PECOS PAC ID: 2567471147 Enrollment ID: I20060410000321 |
| Provider Name | Karen J Dude |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669579041 PECOS PAC ID: 5496752289 Enrollment ID: I20061109000287 |
| Provider Name | Can Bulucu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942309869 PECOS PAC ID: 8527091719 Enrollment ID: I20061226000048 |
| Provider Name | Marti Jo Palmer |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1164567517 PECOS PAC ID: 8921101668 Enrollment ID: I20070316000407 |
| Provider Name | Caryn P Berman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255479648 PECOS PAC ID: 5092815902 Enrollment ID: I20070706000358 |
| Provider Name | Janine L Post-anderle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083768303 PECOS PAC ID: 7810082989 Enrollment ID: I20071004000132 |
| Provider Name | Sangita K Mallick |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629188966 PECOS PAC ID: 2466540570 Enrollment ID: I20071126000508 |
| Provider Name | Shunda M Mcgahee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548396252 PECOS PAC ID: 2860550050 Enrollment ID: I20081016000157 |
| Provider Name | Susan Lax |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245453398 PECOS PAC ID: 6406915594 Enrollment ID: I20081104000518 |
| Provider Name | Patrick R. Aquino |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821127697 PECOS PAC ID: 4284785775 Enrollment ID: I20090623000443 |
| Provider Name | Marie Pierre P Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124157771 PECOS PAC ID: 4981739208 Enrollment ID: I20100311000854 |
| Provider Name | Urrooj Rehman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205021862 PECOS PAC ID: 5991835548 Enrollment ID: I20100609000308 |
| Provider Name | Paul A Fallon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093889206 PECOS PAC ID: 5890857361 Enrollment ID: I20101215000568 |
| Provider Name | Asma Rashid |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154515286 PECOS PAC ID: 8123208089 Enrollment ID: I20110209000732 |
| Provider Name | Tabby Kinyanjui |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306159496 PECOS PAC ID: 2567644511 Enrollment ID: I20110311000371 |
| Provider Name | Americo E Mello |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1255421103 PECOS PAC ID: 8628256781 Enrollment ID: I20110621000383 |
| Provider Name | Lucy S Hall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477797918 PECOS PAC ID: 3274682315 Enrollment ID: I20111024000768 |
| Provider Name | Janet L Schuchter |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1801984968 PECOS PAC ID: 1052586187 Enrollment ID: I20111219000451 |
| Provider Name | Katherine M Davis |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1912212887 PECOS PAC ID: 3173782414 Enrollment ID: I20120306000996 |
| Provider Name | Mark J Bezanson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730253394 PECOS PAC ID: 2466600226 Enrollment ID: I20120919000816 |
| Provider Name | James G Bouras |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750662532 PECOS PAC ID: 8820240666 Enrollment ID: I20121130000444 |
| Provider Name | Brendan P Wynne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922431063 PECOS PAC ID: 9739315516 Enrollment ID: I20131127000359 |
| Provider Name | Jennifer A Conley Sevier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760631196 PECOS PAC ID: 0648406322 Enrollment ID: I20131203000179 |
| Provider Name | Sarah M Holch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144391418 PECOS PAC ID: 2365534187 Enrollment ID: I20140106000408 |
| Provider Name | Matthew J Box |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245490069 PECOS PAC ID: 5395974133 Enrollment ID: I20140127001512 |
| Provider Name | Laurie E Degrappo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699903773 PECOS PAC ID: 5799914008 Enrollment ID: I20140208000120 |
| Provider Name | Amy L Goldberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922130087 PECOS PAC ID: 5890927842 Enrollment ID: I20140407001170 |
| Provider Name | Marion C Mello |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942613617 PECOS PAC ID: 1052538675 Enrollment ID: I20140805002514 |
| Provider Name | Mary M Bazylewicz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669758397 PECOS PAC ID: 7810116209 Enrollment ID: I20140917001242 |
| Provider Name | Darcie A Setera |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528174281 PECOS PAC ID: 9638399512 Enrollment ID: I20140926001154 |
| Provider Name | Scholastica C Nwadiugwu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194141788 PECOS PAC ID: 1658683016 Enrollment ID: I20150629000903 |
| Provider Name | Jamie L King |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013347798 PECOS PAC ID: 5991001026 Enrollment ID: I20160315002347 |
| Provider Name | Alice Karanu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275932485 PECOS PAC ID: 2466741376 Enrollment ID: I20160517000719 |
| Provider Name | Mary Capobianco Korpi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538487202 PECOS PAC ID: 0840574323 Enrollment ID: I20170301000010 |
| Provider Name | Caroline B Brien |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437346665 PECOS PAC ID: 0941585095 Enrollment ID: I20170403000094 |
| Provider Name | Alyssa Hamel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861766883 PECOS PAC ID: 5395018253 Enrollment ID: I20170829002395 |
| Provider Name | Pavlina Monova |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619208006 PECOS PAC ID: 4789712605 Enrollment ID: I20171101002041 |
| Provider Name | Anitha Dayalan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902225311 PECOS PAC ID: 4789802679 Enrollment ID: I20180504000586 |
| Provider Name | Maribel Cruz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902925464 PECOS PAC ID: 2466704598 Enrollment ID: I20181017002520 |
| Provider Name | Kimberly A Obrien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275013047 PECOS PAC ID: 6709120926 Enrollment ID: I20181129000153 |
| Provider Name | Brian Quigley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952844680 PECOS PAC ID: 6103154984 Enrollment ID: I20190819002505 |
| Provider Name | Christopher R Deiulio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811020860 PECOS PAC ID: 8527493758 Enrollment ID: I20200116002386 |
| Provider Name | Shannon E Quinn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699124750 PECOS PAC ID: 2163859364 Enrollment ID: I20200228000879 |
| Provider Name | Bianca Dipersio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811411200 PECOS PAC ID: 0345678462 Enrollment ID: I20200323002945 |
| Provider Name | Ann Elizabeth Olson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396031548 PECOS PAC ID: 6901235381 Enrollment ID: I20200406002898 |
| Provider Name | Sarah E Milnor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922552397 PECOS PAC ID: 0446679229 Enrollment ID: I20200928002336 |
| Provider Name | Mackenzie P Adell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679988208 PECOS PAC ID: 2264843978 Enrollment ID: I20201202001508 |
| Provider Name | Michelle R Silkes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447753926 PECOS PAC ID: 2860423654 Enrollment ID: I20210301001773 |
| Provider Name | Janelle D Bruno |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952858870 PECOS PAC ID: 3375952468 Enrollment ID: I20210430001214 |
| Provider Name | Rhina R Houston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679030159 PECOS PAC ID: 5698171569 Enrollment ID: I20210901002814 |
| Provider Name | Gabrielle E Rizzo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275013963 PECOS PAC ID: 4880083211 Enrollment ID: I20211105000631 |
| Provider Name | Kristy A Morrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750994430 PECOS PAC ID: 2567856602 Enrollment ID: I20220307000192 |
| Provider Name | Jessica L Cooney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659920411 PECOS PAC ID: 6608263124 Enrollment ID: I20220429001771 |
| Provider Name | Rachel M Gedansky |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326559519 PECOS PAC ID: 7911384649 Enrollment ID: I20220518000441 |
| Provider Name | Bryan Edward Mcmullen Harter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679054803 PECOS PAC ID: 6002299161 Enrollment ID: I20220823000737 |
| Provider Name | James E Barrett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144952466 PECOS PAC ID: 4082071311 Enrollment ID: I20230601001249 |
| Provider Name | Leslie C Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538305172 PECOS PAC ID: 1759733439 Enrollment ID: I20240118000984 |
| Provider Name | Marike S Sevigny-morrissey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184250441 PECOS PAC ID: 0749623585 Enrollment ID: I20240208001058 |
Atentiv Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Cummings Ctr Ste 451c, Beverly, MA 01915 Phone: 508-954-0494 | |
North Shore Counseling Center Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 23 Broadway, Beverly, MA 01915 Phone: 978-922-2280 Fax: 978-927-1758 | |
Beacon Counseling Services Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 140 Elliott St Ste 5, Beverly, MA 01915 Phone: 978-473-1346 | |
Megan Grandon Licsw Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 65 Dodge St Unit C, North Beverly Plaza #1016, Beverly, MA 01915 Phone: 978-219-4119 | |
Dba Scott R. Olson Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 500 Cummings Center Suite 5350, North Shore Psychiatry Center, Beverly, MA 01915 Phone: 978-922-8600 Fax: 978-922-8601 | |
Clinical Solutions, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Cummings Ctr, Suite 457 -j, Beverly, MA 01915 Phone: 617-955-9228 | |
Medical Psychology Center, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 100 Cummings Ctr, Suite 456j, Beverly, MA 01915 Phone: 978-921-4000 Fax: 978-921-7530 |