NPIMap

Organization Active NPI

Aviva Mental Health Services Inc

  • Case Management Agency
  • Collingdale, PA
National Provider Identifier
1215696430
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
AVIVA MENTAL HEALTH SERVICES INC
Practice address
320 Macdade Blvd Ste 205
Collingdale, PA 19023-1926
Phone
(610) 522-4506
Fax
(610) 522-4508
NPI assigned
Dec 15, 2021
Last updated
Dec 15, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
AVIVA MENTAL HEALTH SERVICES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Authorized official

Name
Susmaria CharlesNPI 1124383914
Title
Director
Phone
(610) 522-4506

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
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

320 Macdade Blvd Ste 205
Collingdale, PA 19023-1926

Mailing address

320 Macdade Blvd Ste 205
Collingdale, PA 19023-1926
Phone (610) 522-4506

Other identifiers 1

IdentifierTypeStateIssuer
1034994870001MedicaidPA

Other names 1

  • Aviva mental Health Services, inc Former legal business name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address scharles807@avivamhs.com Direct

National Provider Directory

National Provider Directory
Tax ID family
Aviva Mental Health Services6 organizations share this tax ID, including this one
Part of
Aviva Mental Health Services

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • Direct secure messaging: scharles807@avivamhs.com

Practitioners & affiliated clinicians

Practitioners 1

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": "1639526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639526400000",
    "number": "1215696430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 MACDADE BLVD STE 205",
            "city": "COLLINGDALE",
            "state": "PA",
            "postal_code": "190231926",
            "telephone_number": "610-522-4506",
            "fax_number": "610-522-4508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 MACDADE BLVD STE 205",
            "city": "COLLINGDALE",
            "state": "PA",
            "postal_code": "190231926",
            "telephone_number": "610-522-4506",
            "fax_number": "610-522-4508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVIVA MENTAL HEALTH SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AVIVA MENTAL HEALTH SERVICES INC",
        "enumeration_date": "2021-12-15",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-14",
        "status": "A",
        "authorized_official_last_name": "CHARLES",
        "authorized_official_first_name": "SUSMARIA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "610-522-4506"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1034994870001",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "scharles807@avivamhs.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "320 MacDade Blvd Ste 205",
            "city": "Collingdale",
            "state": "PA",
            "country_code": "US",
            "postal_code": "190231926",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Aviva mental Health Services, inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Collingdale, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.