NPIMap

Organization Active NPI

Integrated Behavioral Care New England LLC

  • Counselor
  • North Andover, MA
National Provider Identifier
1053185272
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
INTEGRATED BEHAVIORAL CARE NEW ENGLAND LLC
Practice address
800 Turnpike St Ste 300
North Andover, MA 01845-6156
Phone
(978) 296-5595
Fax
(978) 296-5594
NPI assigned
Nov 8, 2023
Last updated
Nov 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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

Authorized official

Name
Meeting Mouzakis, LICSW, LEP
Title
Executive Director
Phone
(978) 886-2359

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU
Counselor 101Y00000X NU Primary
Clinical Psychologist 103TC0700X NU
Clinical Social Worker 1041C0700X NU
Marriage & Family Therapist 106H00000X NU

Addresses

Primary practice location

800 Turnpike St Ste 300
North Andover, MA 01845-6156

Mailing address

431 Johnson St
North Andover, MA 01845-4721
Phone (978) 886-2359

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240219002188 MA Part B Supplier - Clinic/Group Practice 2860836715 Receives reassigned benefits from 35 practitioners
Practice locations: North Andover, MA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 37

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1699401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699401600000",
    "number": "1053185272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 JOHNSON ST",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018454721",
            "telephone_number": "978-886-2359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 TURNPIKE ST STE 300",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018456156",
            "telephone_number": "978-296-5595",
            "fax_number": "978-296-5594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED BEHAVIORAL CARE NEW ENGLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-08",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A",
        "authorized_official_last_name": "MOUZAKIS",
        "authorized_official_first_name": "MEETING",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "978-886-2359",
        "authorized_official_credential": "LICSW, LEP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Andover, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.