Active NPI
Ruth Yadira Haddock
- Mental Health Counselor
- Holyoke, MA
National Provider Identifier
1194262972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 235 Maple St
Holyoke, MA 01040 - Phone
- (413) 532-0389
- Fax
- (413) 532-1548
- NPI assigned
- Jan 31, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
235 Maple St
Holyoke, MA 01040
Mailing address
235 Maple St
Holyoke, MA 01040-5117
Phone (413) 532-0389
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194262972 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
230 Maple St
Holyoke, MA 01040-5144
Phone (413) 420-2200
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11513 | MA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holyoke Health Center Inc. | Current | Accepting new patients | |
| Holyoke Health Center Inc. | Current | Accepting new patients | |
| Chicopee Health Center Pharmacy | Current | Accepting new patients | |
| Behavioral Health Network, Inc | Past | Accepting new patients |
Locations
505 Front St
Chicopee, MA 01013
Phone (413) 420-2222
230 Maple St
Holyoke, MA 01040
Phone (413) 322-7380
Interoperability endpoints
- rhaddock44163@direct.ctc.masshiway.net
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community Health Clinic/Center
- Holyoke, MA
- NPI 1740271022
-
- Community/Retail Pharmacy
- Chicopee, MA
- NPI 1861720583
-
- Community Health Clinic/Center
- Chicopee, MA
- NPI 1518948595
-
- Methadone Clinic
- Springfield, MA
- NPI 1669017653
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687737600000",
"number": "1194262972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "235 MAPLE ST",
"city": "HOLYOKE",
"state": "MA",
"postal_code": "010405117",
"telephone_number": "413-532-0389",
"fax_number": "413-532-1548"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "235 MAPLE ST",
"city": "HOLYOKE",
"state": "MA",
"postal_code": "01040",
"telephone_number": "413-532-0389",
"fax_number": "413-532-1548"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HADDOCK",
"first_name": "RUTH",
"middle_name": "YADIRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-01-31",
"last_updated": "2023-06-26",
"certification_date": "2023-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1194262972",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Holyoke, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 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; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.