Organization Active NPI

New England Behavioral Health Services Inc

  • Addiction (Substance Use Disorder) Counselor
  • Brockton, MA
National Provider Identifier
1104202415
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
NEW ENGLAND BEHAVIORAL HEALTH SERVICES INC
Practice address
1351 Main St
Brockton, MA 02301-7153
Phone
(508) 857-0239
Fax
(508) 857-0684
NPI assigned
Aug 10, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2021

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

Authorized official

Name
Felicia S Van Rader
Title
Administrator
Phone
(617) 799-6915

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X Primary
Community/Behavioral Health Agency 251S00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

1351 Main St
Brockton, MA 02301-7153

Mailing address

1351 Main St
Brockton, MA 02301-7153

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260114003252 MA Part B Supplier - Clinic/Group Practice 3678059136 Receives reassigned benefits from 1 practitioner
Practice locations: Brockton, MA

National Provider Directory

National Provider Directory

Locations

369 Court St
Brockton, MA 02302

1351 Main St
Ste 102
Brockton, MA 02301
Phone (508) 272-7561

Practitioners & affiliated clinicians

Practitioners 1

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": "1439164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626048000000",
    "number": "1104202415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 MAIN ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023017153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 MAIN ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023017153",
            "telephone_number": "508-857-0239",
            "fax_number": "508-857-0684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW ENGLAND BEHAVIORAL HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-10",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A",
        "authorized_official_last_name": "VAN RADER",
        "authorized_official_first_name": "FELICIA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "617-799-6915"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "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": false
        }
    ],
    "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 Jul 12, 2021; 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.