NPIMap

Organization Active NPI

Northeast Behavioral Services, Inc.

  • Community/Behavioral Health Agency
  • Mansfield, MA
National Provider Identifier
1174107676
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
NORTHEAST BEHAVIORAL SERVICES, INC.
Practice address
15 West St
Mansfield, MA 02048-2424
Phone
(774) 219-7398
NPI assigned
May 11, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2021

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

Authorized official

Name
Justin Valanzola, M.ED, LABA, BCBANPI 1376085043
Title
Owner
Phone
(774) 219-7398

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
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

15 West St
Mansfield, MA 02048-2424

Mailing address

15 West St
Mansfield, MA 02048-2424
Phone (774) 219-7398

National Provider Directory

National Provider Directory

Locations

15 West St
Mansfield, MA 02048
Phone (774) 219-7398

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": "1620691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620864000000",
    "number": "1174107676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 WEST ST",
            "city": "MANSFIELD",
            "state": "MA",
            "postal_code": "020482424",
            "telephone_number": "774-219-7398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 WEST ST",
            "city": "MANSFIELD",
            "state": "MA",
            "postal_code": "020482424",
            "telephone_number": "774-219-7398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST BEHAVIORAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-11",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A",
        "authorized_official_last_name": "VALANZOLA",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "774-219-7398",
        "authorized_official_credential": "M.ED, LABA, BCBA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.