| The Plymouth Center For Behavioral Health | |
|
81 Samoset St Plymouth MA 02360-4500 | |
| (085) 830-0012 | |
| (508) 830-0092 |
| Full Name | The Plymouth Center For Behavioral Health |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 81 Samoset St, Plymouth, Massachusetts |
| Authorized Official Name and Position | Julie A Johnson (ADMINISTRATER) |
| Authorized Official Contact | 5088300012 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Plymouth Center For Behavioral Health 81 Samoset St Plymouth MA 02360-4500 Ph: (508) 830-0012 | The Plymouth Center For Behavioral Health 81 Samoset St Plymouth MA 02360-4500 Ph: (085) 830-0012 |
| NPI Number | 1154457422 |
|---|---|
| Provider Enumeration Date | 02/23/2007 |
| Last Update Date | 09/06/2023 |
| Certification Date | 08/18/2022 |
| Medicare PECOS PAC ID | 9335242510 |
|---|---|
| Medicare Enrollment ID | O20070308000096 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154457422 | NPI | - | NPPES |
| M21909 | Other | IDK | |
| M21909 | Other | SOCIAL WORKERS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Kristine M Duhamel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861534588 PECOS PAC ID: 3375576549 Enrollment ID: I20050917000075 |
| Provider Name | Lori Hixon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538464896 PECOS PAC ID: 4082898804 Enrollment ID: I20110401000712 |
| Provider Name | Susan M Ramondetta |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912201542 PECOS PAC ID: 3577749373 Enrollment ID: I20110512000012 |
| Provider Name | Dwight G Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831309020 PECOS PAC ID: 0446410773 Enrollment ID: I20120324000001 |
| Provider Name | Erica B St Germain |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437418605 PECOS PAC ID: 6608027222 Enrollment ID: I20121108000060 |
| Provider Name | Erin Rauscher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629271119 PECOS PAC ID: 5799729067 Enrollment ID: I20140430002451 |
| Provider Name | Elizabeth M Zaccardi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275717084 PECOS PAC ID: 5294955068 Enrollment ID: I20140929001678 |
| Provider Name | Colin Mcwilliams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396464319 PECOS PAC ID: 5991174021 Enrollment ID: I20221213001944 |
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