NPIMap

Organization Active NPI

Brockton Multi Service

  • Mental Health Counselor
  • Brockton, MA
National Provider Identifier
1043355266
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
4912 Issued in MA
Legal business name
BROCKTON MULTI SERVICE
Practice address
165 Quincy St
DMH
Brockton, MA 02302-2988
Phone
(508) 897-2000
Fax
(508) 586-5117
NPI assigned
Feb 21, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Richard Jobin, LICSW
Title
Director
Phone
(508) 897-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 4912 MA Primary

Addresses

Primary practice location

165 Quincy St
DMH
Brockton, MA 02302-2988

Mailing address

165 Quincy St
DMH
Brockton, MA 02302-2988
Phone (508) 897-2000

National Provider Directory

National Provider Directory
Tax ID family
Quincy Mental Health Center147 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043355266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 QUINCY ST",
            "address_2": "DMH",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023022988",
            "telephone_number": "508-897-2000",
            "fax_number": "508-586-5117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 QUINCY ST",
            "address_2": "DMH",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023022988",
            "telephone_number": "508-897-2000",
            "fax_number": "508-586-5117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROCKTON MULTI SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOBIN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "508-897-2000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "4912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.