Jecc Behavioral Center

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

JECC BEHAVIORAL CENTER

Practice address

21 Annis St
North Andover, MA 01845-3401

Phone

(978) 289-7258

NPI assigned

Dec 20, 2021

Organization subpart

No

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

Authorized official

Name

Virginie KamueneNPI 1720539182

Title

Ceo

Phone

(978) 289-7258

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Locations

Practitioners 4

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.

• Jeannette Jimenez, SOCIAL WORKER

  • Clinical Social Worker
  • Lawrence, MA
  • NPI 1932680394
  Medicare reassignment NPD
• Virginie Kasiama Kamuene, IHT/BA ICC, FP

  • Counselor
  • Lawrence, MA
  • NPI 1720539182
  NPD Authorized official
• Joshua Wanganga, LABA

  • Behavior Analyst
  • North Andover, MA
  • NPI 1609509751
  NPD
• Edwin Paukert, LMHC

  • Mental Health Counselor
  • Haverhill, MA
  • NPI 1538378799
  NPD (past)

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

{
    "created_epoch": "1639958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639958400000",
    "number": "1215697131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 ANNIS ST",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018453401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 ANNIS ST",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018453401",
            "telephone_number": "978-289-7258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JECC BEHAVIORAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-20",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A",
        "authorized_official_last_name": "KAMUENE",
        "authorized_official_first_name": "VIRGINIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "978-289-7258"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isd Renal Inc (North Andover Renal Center)
• Isentcare LLC
• Walter H. Jacobs, MD
• Janette L. Liu, OD and Associates, LLC (North Andover Eye Care)
• Jacqueline Jean-Pierre
• Jennifer Leslie PSYD LLC
• Joan I. Gitlin, M. D.
• John a Schrader DMD PC Dba Willows Dental Group
• John Ohoro
• John P. Cogliano, D.M.D., P.C.

• Addiction (Substance Use Disorder) Counselor in North Andover, MA
• Providers in North Andover, MA by specialty
• Addiction (Substance Use Disorder) Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; 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.