Individual provider Active NPI

Ruth Yadira Haddock

  • Mental Health Counselor
  • Holyoke, MA
National Provider Identifier
1194262972
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
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

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1194262972MedicaidMA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220824000341 MA Practitioner - Clinical Psychologist 0244613289 Reassigns benefits to 1 organization

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
Holyoke Health Center Inc.Group PAC ID 8527969302, 40 clinicians

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

LicenseStateTypeSpecialty
11513MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Holyoke Health Center Inc. CurrentSince Feb 6, 2023 Accepting new patients
Holyoke Health Center Inc. Current Accepting new patients
Chicopee Health Center Pharmacy CurrentSince Feb 6, 2023 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.