| North Suffolk Community Services Inc. | |
|
14 Porter St East Boston MA 02128-2116 | |
| (617) 569-3189 | |
| (617) 569-7890 |
| Full Name | North Suffolk Community Services Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 14 Porter St, East Boston, Massachusetts |
| Authorized Official Name and Position | Judi Lemoine (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6179127910 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Suffolk Community Services Inc. 301 Broadway Chelsea MA 02150-2807 Ph: (617) 889-4860 | North Suffolk Community Services Inc. 14 Porter St East Boston MA 02128-2116 Ph: (617) 569-3189 |
| NPI Number | 1740209881 |
|---|---|
| Provider Enumeration Date | 07/19/2006 |
| Last Update Date | 05/17/2024 |
| Medicare PECOS PAC ID | 9234037516 |
|---|---|
| Medicare Enrollment ID | O20040331000751 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740209881 | NPI | - | NPPES |
| 1301659 | Medicaid | MA | |
| 1301926 | Medicaid | MA | |
| 1303147 | Medicaid | MA | |
| 708502 | Other | MA | TUFTS HEALTH PLANS |
| 1304178 | Medicaid | MA | |
| 214325 | Other | MA | MAGELLAN BEHAVIORAL HLTH |
| 996251-01 | Other | MA | NETWORK HEALTH |
| 1307398 | Medicaid | MA | |
| A011775 | Other | MA | MASS. BEHAVIORAL HEALTH PARTNERSHIP |
| 7216 | Other | MA | BMC HEALTHNET |
| A012487 | Other | MA | MASS. BEHAVIORAL HEALTH PARTNERSHIP NODDLES ISLAND |
| 1002420 | Other | MA | BEACON HEALTH STRATEGIES |
| M18732 | Other | MA | BLUE CROSS OF MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 4027 (Massachusetts) | Primary |
| Provider Name | Deborah S Robbins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982731139 PECOS PAC ID: 2062446933 Enrollment ID: I20050920001057 |
| Provider Name | Sandra T Polcari |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225171440 PECOS PAC ID: 8123120557 Enrollment ID: I20070302000407 |
| Provider Name | Kevin S Reddall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871752824 PECOS PAC ID: 5092991851 Enrollment ID: I20110512000773 |
| Provider Name | Meredith Anne Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730497157 PECOS PAC ID: 5395967343 Enrollment ID: I20141107000470 |
| Provider Name | Samantha W Green-atchley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225317811 PECOS PAC ID: 3072827823 Enrollment ID: I20150806011889 |
| Provider Name | Tina T Holland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699179408 PECOS PAC ID: 2860776234 Enrollment ID: I20170302001291 |
| Provider Name | Katherine A Thayer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720360134 PECOS PAC ID: 4183987969 Enrollment ID: I20180409000474 |
| Provider Name | Emily T Lopiccolo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083088009 PECOS PAC ID: 9931458262 Enrollment ID: I20180821000493 |
| Provider Name | Leia B Zitola |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043364151 PECOS PAC ID: 2567892581 Enrollment ID: I20200415000873 |
| Provider Name | Audrey Clairmont |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043690530 PECOS PAC ID: 9830441260 Enrollment ID: I20210127002888 |
| Provider Name | Kristen Robertson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942757752 PECOS PAC ID: 8729487301 Enrollment ID: I20210602001108 |
| Provider Name | Sara Vanschaik |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396228532 PECOS PAC ID: 5991197014 Enrollment ID: I20220124001799 |
| Provider Name | Claudia Contreras |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104172097 PECOS PAC ID: 4688043193 Enrollment ID: I20221205003178 |
| Provider Name | Griselda Kristen Tomaino |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912307539 PECOS PAC ID: 7517312259 Enrollment ID: I20231016001617 |
| Provider Name | Marianne Fuentes-carpentier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548834559 PECOS PAC ID: 2860840410 Enrollment ID: I20231121001391 |
| Provider Name | Caroline Marchetta |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437606365 PECOS PAC ID: 1850743865 Enrollment ID: I20240116000802 |
| Provider Name | Marzieh Bonakdarhashemi |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568981421 PECOS PAC ID: 7517310162 Enrollment ID: I20240130002976 |
| Provider Name | Shannon Lucia Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760150627 PECOS PAC ID: 7517310949 Enrollment ID: I20240201000739 |
| Provider Name | Kelly Christian |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831565746 PECOS PAC ID: 0345693727 Enrollment ID: I20240201002582 |
| Provider Name | Gregory Charles Zeltt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225653116 PECOS PAC ID: 9133562226 Enrollment ID: I20240206001013 |
| Provider Name | Nicole Ubaldi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902275118 PECOS PAC ID: 8022458959 Enrollment ID: I20240425002574 |
| Provider Name | Pilar Angela Marie Caguioa |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588206544 PECOS PAC ID: 2567802879 Enrollment ID: I20240503001947 |
| Provider Name | Buneshte Kombiz Hakhamaneshy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508472523 PECOS PAC ID: 6800338880 Enrollment ID: I20240605002299 |
| Provider Name | Stephanie June Conti |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144861006 PECOS PAC ID: 6901345560 Enrollment ID: I20240827001939 |
| Provider Name | Stephanie Rose Modrak |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427641208 PECOS PAC ID: 3870024813 Enrollment ID: I20241002000588 |
| Provider Name | Theoni Kolas |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982324828 PECOS PAC ID: 4082145024 Enrollment ID: I20241002000813 |
| Provider Name | John Matthew Axten |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588394969 PECOS PAC ID: 3678008729 Enrollment ID: I20241126001499 |
| Provider Name | Sarah Maeder |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477254779 PECOS PAC ID: 0648709469 Enrollment ID: I20250123002688 |
| Provider Name | Monica Thomas |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730554023 PECOS PAC ID: 2264957380 Enrollment ID: I20250421002562 |
| Provider Name | Lilian Beatriz Lopes De Andrade |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588182653 PECOS PAC ID: 0941727655 Enrollment ID: I20250506003243 |
Medical Associates Of Ebnhc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10 Gove St, East Boston, MA 02128 Phone: 617-569-5800 Fax: 617-568-4780 | |
Neighborhealth Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 10 Gove St, East Boston, MA 02128 Phone: 617-569-5800 Fax: 617-568-4756 | |
Excel Physical Therapy, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2 Neptune Rd Suite 171, East Boston, MA 02128 Phone: 617-895-7684 | |
Internal Medical Associates-ebnhc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 10 Gove St, East Boston, MA 02128 Phone: 617-569-5800 Fax: 617-568-4756 | |
Central Square Medical Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 40 Central Sq, East Boston, MA 02128 Phone: 617-202-9036 | |
American Current Care Of Massachusetts Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Harborside Dr, East Boston, MA 02128 Phone: 617-265-6500 Fax: 617-568-6573 |