NPIMap

Organization Active NPI

South Shore Center Inc

  • Group Psychotherapy Psychologist
  • Charlestown, RI
National Provider Identifier
1255327391
Registry record updated Jan 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Group Psychotherapy PsychologistTaxonomy code 103TP2701X
Legal business name
SOUTH SHORE CENTER INC
Practice address
4705A Old Post Rd
Charlestown, RI 02813-1819
Phone
(401) 364-7705
Fax
(401) 364-9104
NPI assigned
Sep 23, 2005
Last updated
Jan 24, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2013

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

Authorized official

Name
Dorothy A Yeamen, MPA
Title
Coo
Phone
(401) 364-7705

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X
Group Psychotherapy Psychologist 103TP2701X Primary
Social Worker 104100000X
Clinical Social Worker 1041C0700X
Marriage & Family Therapist 106H00000X

Addresses

Primary practice location

4705A Old Post Rd
Charlestown, RI 02813-1819

Mailing address

PO Box 899
Charlestown, RI 02813-0899
Phone (401) 364-7705

Other identifiers 4

IdentifierTypeStateIssuer
201774OtherRIBLUE CHIP GROUP ID
9001875MedicaidRI
25450OtherRIBLUE CROSS GROUP ID
SS02237MedicaidRI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 80

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.

View all 80

NPI Registry JSON

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358985600000",
    "number": "1255327391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 899",
            "city": "CHARLESTOWN",
            "state": "RI",
            "postal_code": "028130899",
            "telephone_number": "401-364-7705",
            "fax_number": "401-364-9104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4705A OLD POST RD",
            "city": "CHARLESTOWN",
            "state": "RI",
            "postal_code": "028131819",
            "telephone_number": "401-364-7705",
            "fax_number": "401-364-9104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SHORE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-23",
        "last_updated": "2013-01-24",
        "status": "A",
        "authorized_official_last_name": "YEAMEN",
        "authorized_official_first_name": "DOROTHY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "401-364-7705",
        "authorized_official_credential": "MPA"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP GROUP ID",
            "identifier": "201774",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9001875",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GROUP ID",
            "identifier": "25450",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SS02237",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlestown, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2013; 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.