NPIMap

Organization Active NPI

Aviva Mental Health Services Inc

  • Community/Behavioral Health Agency
  • Wilmington, DE
National Provider Identifier
1144830738
Registry record updated Aug 7, 2020
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
219 W 9TH St
Wilmington, DE 19801-1619
Phone
(610) 522-4506
Fax
(610) 522-4508
NPI assigned
Aug 7, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2020

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

Authorized official

Name
Mrs. Susmaria Charles, MHS
Title
Ceo
Phone
(610) 522-4506

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Community/Behavioral Health Agency 251S00000X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X

Addresses

Primary practice location

219 W 9TH St
Wilmington, DE 19801-1619

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1034994870001MedicaidPA

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

219 W 9th St
Wilmington, DE 19801
Phone (610) 522-4506

NPI Registry JSON

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

{
    "created_epoch": "1596758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596758400000",
    "number": "1144830738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 MACDADE BLVD STE 205",
            "city": "DARBY",
            "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": "219 W 9TH ST",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198011619",
            "telephone_number": "610-522-4506",
            "fax_number": "610-522-4508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVIVA MENTAL HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-07",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A",
        "authorized_official_last_name": "CHARLES",
        "authorized_official_first_name": "SUSMARIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "610-522-4506",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MHS"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1034994870001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2020; 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.