| The Commonwealth Of Massachusetts | |
|
165 Quincy St Brockton MA 02302-2988 | |
| (508) 897-2069 | |
| Not Available |
| Full Name | The Commonwealth Of Massachusetts |
|---|---|
| Speciality | Clinic/Center |
| Location | 165 Quincy St, Brockton, Massachusetts |
| Authorized Official Name and Position | Mona Mackinnon (CENTER DIRECTOR) |
| Authorized Official Contact | 7742973246 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Commonwealth Of Massachusetts 165 Quincy St Brockton MA 02302-2988 Ph: (508) 897-2069 | The Commonwealth Of Massachusetts 165 Quincy St Brockton MA 02302-2988 Ph: (508) 897-2069 |
| NPI Number | 1326155458 |
|---|---|
| Provider Enumeration Date | 08/24/2006 |
| Last Update Date | 05/03/2023 |
| Certification Date | 05/03/2023 |
| Medicare PECOS PAC ID | 8820906860 |
|---|---|
| Medicare Enrollment ID | O20050203000148 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326155458 | NPI | - | NPPES |
| 1305565 | Medicaid | MA | |
| 2155167 | Other | PK |
| Provider Name | Renee M Sorrentino |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619968625 PECOS PAC ID: 5193614113 Enrollment ID: I20040315000989 |
| Provider Name | Anne L Li |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073695193 PECOS PAC ID: 7911994579 Enrollment ID: I20040427000936 |
| Provider Name | Adriana D Neagoe |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124049002 PECOS PAC ID: 5395715080 Enrollment ID: I20040729000810 |
| Provider Name | Andrew C Bott |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982636403 PECOS PAC ID: 5496792558 Enrollment ID: I20050411001196 |
| Provider Name | Fe Erlita D Festin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326052168 PECOS PAC ID: 4587606439 Enrollment ID: I20050601000607 |
| Provider Name | Judith T Cavanaugh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831238377 PECOS PAC ID: 2567490329 Enrollment ID: I20050802000739 |
| Provider Name | Robert C Anzola |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326181595 PECOS PAC ID: 5890711469 Enrollment ID: I20051022000132 |
| Provider Name | Philip C Mccartin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912082264 PECOS PAC ID: 4688691009 Enrollment ID: I20051025000968 |
| Provider Name | Marc A Cohen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528168804 PECOS PAC ID: 0749295509 Enrollment ID: I20060215000303 |
| Provider Name | Gyula Bokor |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700844354 PECOS PAC ID: 0446266076 Enrollment ID: I20060306000528 |
| Provider Name | Michelle W Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477625218 PECOS PAC ID: 5991896334 Enrollment ID: I20070814000428 |
| Provider Name | Gerald F Donovan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356326623 PECOS PAC ID: 0648362772 Enrollment ID: I20070822000258 |
| Provider Name | Anne M Carter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770697666 PECOS PAC ID: 8224121215 Enrollment ID: I20070907000100 |
| Provider Name | Erin M.c. Carter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144488164 PECOS PAC ID: 4486743259 Enrollment ID: I20071130000500 |
| Provider Name | Theresa Lynne Harpold |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639160336 PECOS PAC ID: 8426137589 Enrollment ID: I20080501000117 |
| Provider Name | Deborah J Dixon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679642235 PECOS PAC ID: 1456491059 Enrollment ID: I20091211000431 |
| Provider Name | Ellen Flynn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699803551 PECOS PAC ID: 9931236833 Enrollment ID: I20100426000177 |
| Provider Name | Rafael I Gracia |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073539276 PECOS PAC ID: 8224212956 Enrollment ID: I20110405000323 |
| Provider Name | Christina L Cronin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194039842 PECOS PAC ID: 5890971287 Enrollment ID: I20110519000551 |
| Provider Name | Paul Weiss |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205989555 PECOS PAC ID: 9739168873 Enrollment ID: I20110721000112 |
| Provider Name | Ujala Fawad |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063662112 PECOS PAC ID: 9335392224 Enrollment ID: I20121228000193 |
| Provider Name | Ronald T Lee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841443470 PECOS PAC ID: 0547490179 Enrollment ID: I20140227001558 |
| Provider Name | Genny I Wolf |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659665909 PECOS PAC ID: 5092932780 Enrollment ID: I20140804000381 |
| Provider Name | Barry C Sanders |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356626857 PECOS PAC ID: 4385865559 Enrollment ID: I20141103000113 |
| Provider Name | Colleen Marie Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770916959 PECOS PAC ID: 1052635935 Enrollment ID: I20150126000068 |
| Provider Name | Ashley A Porter-watkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629407184 PECOS PAC ID: 1658675004 Enrollment ID: I20160205001151 |
| Provider Name | Mark P. Caron |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073865077 PECOS PAC ID: 3779889662 Enrollment ID: I20160302000971 |
| Provider Name | Jeannette M Sorace-burton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780063628 PECOS PAC ID: 2365748621 Enrollment ID: I20160311001736 |
| Provider Name | Suzanne E Bergeron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093020091 PECOS PAC ID: 7618251372 Enrollment ID: I20170225000120 |
| Provider Name | Lorraine Wiley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225551674 PECOS PAC ID: 3173895703 Enrollment ID: I20170817000191 |
| Provider Name | James G Fay |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720524804 PECOS PAC ID: 5092069567 Enrollment ID: I20181120000601 |
| Provider Name | Ryan Francis Horn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114405172 PECOS PAC ID: 5799026159 Enrollment ID: I20190411001973 |
| Provider Name | Nerissa Patricia Fuhrmann |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699169177 PECOS PAC ID: 6305151333 Enrollment ID: I20191204000713 |
| Provider Name | Kathleen None Heffernan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548870710 PECOS PAC ID: 9133538028 Enrollment ID: I20210505001559 |
| Provider Name | Dayina Noel Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346904984 PECOS PAC ID: 1456728823 Enrollment ID: I20221028000616 |
| Provider Name | Giancarlo D Zolfonoon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184394967 PECOS PAC ID: 2860860582 Enrollment ID: I20221130000263 |
| Provider Name | Rachel E Geary |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154044998 PECOS PAC ID: 6204205800 Enrollment ID: I20221202001640 |
| Provider Name | Kiara Rossborough |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972095123 PECOS PAC ID: 8527416726 Enrollment ID: I20231129000761 |
| Provider Name | Michael F. Luongo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467198051 PECOS PAC ID: 6901336114 Enrollment ID: I20250203003022 |
Arbour Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9 Shaw Rd, Brockton, MA 02301 Phone: 617-935-4872 | |
Aubrey Lieberman Md Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1342 Belmont St, Suite 105, Brockton, MA 02301 Phone: 508-580-3330 Fax: 508-580-8633 | |
South Bay Mental Health Center, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1115 West Chestnut Street, Suite 202, Brockton, MA 02301 Phone: 508-521-2200 Fax: 508-584-2227 | |
Boston Medical Center - South Corporation Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 235 N Pearl St, Brockton, MA 02301 Phone: 508-427-3000 | |
Boston Medical Center - South Corporation Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 34 N Pearl St, Brockton, MA 02301 Phone: 508-408-9200 | |
Brockton Multi Service Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 165 Quincy St, Brockton, MA 02302 Phone: 508-897-2166 | |
South Bay Mental Health Center, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1115 West Chestnut Street Suite 202, Brockton, MA 02301 Phone: 508-521-2200 Fax: 508-584-2227 |