NPIMap

Organization Active NPI

Aviva Mental Health Services Inc

  • Community/Behavioral Health Agency
  • Collingdale, PA
National Provider Identifier
1063005965
Registry record updated Feb 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
AVIVA MENTAL HEALTH SERVICES INC
Practice address
320 Macdade Blvd Ste 205
Collingdale, PA 19023-1926
Phone
(610) 522-4506
Fax
(610) 522-4508
NPI assigned
Feb 11, 2021
Last updated
Feb 11, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2021

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

Authorized official

Name
Mrs. Susmaria CharlesNPI 1124383914
Title
Director
Phone
(610) 522-4506

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

320 Macdade Blvd Ste 205
Collingdale, PA 19023-1926

Mailing address

320 Macdade Blvd Ste 205
Collingdale, PA 19023-1926
Phone (610) 522-4506

Other identifiers 1

IdentifierTypeStateIssuer
1083110605MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Aviva Mental Health Serv6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

320 Macdade Blvd
Ste 205
Darby, PA 19023
Phone (610) 522-4506

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1613001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613001600000",
    "number": "1063005965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 MACDADE BLVD STE 205",
            "city": "COLLINGDALE",
            "state": "PA",
            "postal_code": "190231926",
            "telephone_number": "610-522-4506",
            "fax_number": "610-522-4508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 MACDADE BLVD STE 205",
            "city": "COLLINGDALE",
            "state": "PA",
            "postal_code": "190231926",
            "telephone_number": "610-522-4506",
            "fax_number": "610-522-4508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVIVA MENTAL HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-11",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A",
        "authorized_official_last_name": "CHARLES",
        "authorized_official_first_name": "SUSMARIA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "610-522-4506",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083110605",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Collingdale, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; 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.