NPIMap

Organization Active NPI

Aviva Mental Health Services Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Collingdale, PA
National Provider Identifier
1083110605
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
143750 Issued in PA
Legal business name
AVIVA MENTAL HEALTH SERVICES INC
Practice address
14-20 Macdade Blvd Ste a
Collingdale, PA 19023-1822
Phone
(610) 522-4506
Fax
(610) 522-4508
NPI assigned
Apr 3, 2018
Last updated
Oct 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Authorized official

Name
Ms. Susmaria Charles, MHS;CPSSNPI 1124383914
Title
Clinical 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 13

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 143750 PA
Mental Health Counselor 101YM0800X 143750 PA
Psychologist 103T00000X 143750 PA
Clinical Child & Adolescent Psychologist 103TC2200X 143750 PA
Marriage & Family Therapist 106H00000X 143750 PA
Psychiatric/Mental Health Registered Nurse 163WP0808X 143750 PA
Addiction Psychiatry Physician 2084P0802X 143750 PA
Child & Adolescent Psychiatry Physician 2084P0804X 143650 PA
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 143750 PA Primary
Adult Mental Health Clinic/Center 261QM0850X 144120 PA
Adult Mental Health Clinic/Center 261QM0850X 143750 PA
Adolescent and Children Mental Health Clinic/Center 261QM0855X 143750 PA
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 143750 PA

Addresses

Primary practice location

14-20 Macdade Blvd Ste a
Collingdale, PA 19023-1822

Mailing address

14-20 Macdade Blvd Ste a
Collingdale, PA 19023-1822
Phone (610) 522-4506

Other identifiers 2

IdentifierTypeStateIssuer
143750MedicaidPA
144120MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190604000212 PA Part B Supplier - Clinic/Group Practice 6709119944 Receives reassigned benefits from 3 practitioners
Practice locations: Collingdale, PA

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.

Practitioners & affiliated clinicians

Practitioners 9

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": "1522713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761004800000",
    "number": "1083110605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14-20 MACDADE BLVD STE A",
            "city": "COLLINGDALE",
            "state": "PA",
            "postal_code": "190231822",
            "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": "14-20 MACDADE BLVD STE A",
            "city": "COLLINGDALE",
            "state": "PA",
            "postal_code": "190231822",
            "telephone_number": "610-522-4506",
            "fax_number": "610-522-4508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVIVA MENTAL HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-03",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A",
        "authorized_official_last_name": "CHARLES",
        "authorized_official_first_name": "SUSMARIA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "610-522-4506",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MHS;CPSS"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "PA",
            "license": "143750",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "143750",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "143750",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "PA",
            "license": "143750",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "PA",
            "license": "143750",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "PA",
            "license": "143750",
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "PA",
            "license": "143750",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PA",
            "license": "143650",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "PA",
            "license": "143750",
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "PA",
            "license": "144120",
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "PA",
            "license": "143750",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "PA",
            "license": "143750",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "PA",
            "license": "143750",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143750",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144120",
            "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 Oct 21, 2025; 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.