NPIMap

Organization Active NPI

Reunited

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Quincy, MA
National Provider Identifier
1124731476
Registry record updated Jan 26, 2023
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
REUNITED
Practice address
1354 Hancock St Ste 205
Quincy, MA 02169-5109
Phone
(857) 939-4445
NPI assigned
Jan 3, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Authorized official

Name
Brandon Gholson, LCSWNPI 1639420011
Title
Intake Coordinator
Phone
(857) 939-4445

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

1354 Hancock St Ste 205
Quincy, MA 02169-5109

Mailing address

1354 Hancock St Ste 205
Quincy, MA 02169-5109
Phone (857) 939-4445

Other identifiers 1

IdentifierTypeStateIssuer
1366796070MedicaidMA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brandon@reunitedservices.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230202000117 MA Part B Supplier - Clinic/Group Practice 1355713264 Receives reassigned benefits from 1 practitioner
Practice locations: Quincy, MA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1672704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674691200000",
    "number": "1124731476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1354 HANCOCK ST STE 205",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021695109",
            "telephone_number": "857-939-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1354 HANCOCK ST STE 205",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021695109",
            "telephone_number": "857-939-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REUNITED",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-03",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-24",
        "status": "A",
        "authorized_official_last_name": "GHOLSON",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "INTAKE COORDINATOR",
        "authorized_official_telephone_number": "857-939-4445",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366796070",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brandon@reunitedservices.com",
            "affiliation": "N",
            "address_1": "1354 Hancock St Ste 205",
            "city": "Quincy",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021695109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.