Individual provider Active NPI

Judy Selman

  • Community/Behavioral Health Agency
  • Roxbury, MA
National Provider Identifier
1215396833
Registry record updated Feb 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Practice address
11 Roxbury St
2ND Floor
Roxbury, MA 02119-1720
Phone
(617) 516-0280
Fax
(617) 516-0281
NPI assigned
Feb 11, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MA Primary

Addresses

Primary practice location

11 Roxbury St
2ND Floor
Roxbury, MA 02119-1720

Mailing address

11 Roxbury St
2ND Floor
Roxbury, MA 02119-1720
Phone (617) 516-0280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mattick Behavioral Health Services Inc CurrentSince Dec 28, 2022 Accepting new patients

Locations

1400 Hancock St
Fl 9
Quincy, MA 02169
Phone (617) 936-8588

Organizations & group practices 1

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": "1455148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455148800000",
    "number": "1215396833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 ROXBURY ST",
            "address_2": "2ND FLOOR",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021191720",
            "telephone_number": "617-516-0280",
            "fax_number": "617-516-0281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 ROXBURY ST",
            "address_2": "2ND FLOOR",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021191720",
            "telephone_number": "617-516-0280",
            "fax_number": "617-516-0281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELMAN",
        "first_name": "JUDY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-11",
        "last_updated": "2016-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roxbury, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2016; 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.