NPIMap

Organization Active NPI

Carelon Behavioral Care, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Boston, MA
National Provider Identifier
1053894790
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
CARELON BEHAVIORAL CARE, INC.
Practice address
200 State St Ste 302
Boston, MA 02109-2672
Phone
(978) 846-6340
Fax
(888) 733-9280
NPI assigned
Sep 10, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Authorized official

Name
Angela Edmonds
Title
General Manager
Phone
(855) 227-6562

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X
Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 104100000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

200 State St Ste 302
Boston, MA 02109-2672

Mailing address

200 State St Ste 302
Boston, MA 02109-2672
Phone (855) 227-6562

Other names 1

  • Beacon Health Options Care Services, Inc. Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230118002506 NY Part B Supplier - Clinic/Group Practice 6608113477 Practice locations: New York, NY
O20240807000652 NC Part B Supplier - Clinic/Group Practice 6608113477 Receives reassigned benefits from 1 practitioner
Practice locations: Fayetteville, NC

National Provider Directory

National Provider Directory

Locations

200 State St
Ste 302
Boston, MA 02109
Phone (978) 846-6340

1590 Skibo Rd
Ste 101
Fayetteville, NC 28303
Phone (910) 717-0676

1213 E Trinity Mills Rd
Carrollton, TX 75006
Phone (214) 483-3020

1400 Crossways Blvd
Ste 101
Chesapeake, VA 23320

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1536537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731888000000",
    "number": "1053894790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 STATE ST STE 302",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021092672",
            "telephone_number": "855-227-6562",
            "fax_number": "888-733-9280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 STATE ST STE 302",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021092672",
            "telephone_number": "978-846-6340",
            "fax_number": "888-733-9280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARELON BEHAVIORAL CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-10",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A",
        "authorized_official_last_name": "EDMONDS",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "855-227-6562"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beacon Health Options Care Services, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; 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.