NPIMap

Organization Active NPI

Emh Associates, PLLC

Doing business as Ellie Mental Health-Andover

  • Clinical Social Worker
  • Andover, MA
National Provider Identifier
1215618210
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
EMH ASSOCIATES, PLLC
Doing business as
Ellie Mental Health-Andover
Practice address
2 Dundee Park Dr Ste 301
Andover, MA 01810-3725
Phone
(617) 256-7616
NPI assigned
Jul 31, 2023
Last updated
Jul 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Authorized official

Name
Mrs. Nicole Frances Fagone, LICSWNPI 1245272798
Title
Clinical Director
Phone
(617) 256-7616

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

2 Dundee Park Dr Ste 301
Andover, MA 01810-3725

Mailing address

640 Andover St
Lowell, MA 01852-1532
Phone (617) 256-7616

Other names 1

  • Ellie Mental Health-Andover Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231226001407 MA Part B Supplier - Clinic/Group Practice 0941650469 Receives reassigned benefits from 6 practitioners
Practice locations: Andover, MA; Woburn, MA

National Provider Directory

National Provider Directory

Locations

2 Dundee Park Dr
Ste 301
Andover, MA 01810
Phone (617) 256-7616

800 W Cummings Park
Ste 5050
Woburn, MA 01801
Phone (603) 769-1126

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690761600000",
    "number": "1215618210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 ANDOVER ST",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018521532",
            "telephone_number": "617-256-7616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 DUNDEE PARK DR STE 301",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018103725",
            "telephone_number": "617-256-7616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMH ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-31",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A",
        "authorized_official_last_name": "FAGONE",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "FRANCES",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "617-256-7616",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ellie Mental Health-Andover",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Andover, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.