NPIMap

Organization Active NPI

Academic & Behavioral Clinic

  • Community/Behavioral Health Agency
  • Dorchester Center, MA
National Provider Identifier
1265645261
Registry record updated Feb 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
4D1R Issued in MA
Legal business name
ACADEMIC & BEHAVIORAL CLINIC
Practice address
995 Blue Hill Ave
Dorchester Center, MA 02124-2828
Phone
(617) 822-0829
Fax
(617) 825-7804
NPI assigned
May 7, 2007
Last updated
Feb 16, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2012

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

Authorized official

Name
Dr. Terri BettsNPI 1730392812
Title
Executive Director
Phone
(617) 822-0829

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
Community/Behavioral Health Agency 251S00000X 4D1R MA Primary

Addresses

Primary practice location

995 Blue Hill Ave
Dorchester Center, MA 02124-2828

Mailing address

PO Box 190789
Boston, MA 02119-0015
Phone (617) 822-0829

National Provider Directory

National Provider Directory

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": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329350400000",
    "number": "1265645261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190789",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021190015",
            "telephone_number": "617-822-0829",
            "fax_number": "617-825-7804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "995 BLUE HILL AVE",
            "city": "DORCHESTER CENTER",
            "state": "MA",
            "postal_code": "021242828",
            "telephone_number": "617-822-0829",
            "fax_number": "617-825-7804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACADEMIC & BEHAVIORAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2012-02-16",
        "status": "A",
        "authorized_official_last_name": "BETTS",
        "authorized_official_first_name": "TERRI",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "617-822-0829",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MA",
            "license": "4D1R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester Center, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2012; 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.