NPIMap

Organization Active NPI

Juvo Behavioral Health of Massachusetts LLC

  • Behavior Analyst
  • Wilmington, MA
National Provider Identifier
1265949754
Registry record updated Mar 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
9 Issued in MA
Legal business name
JUVO BEHAVIORAL HEALTH OF MASSACHUSETTS LLC
Practice address
64H Concord St
Wilmington, MA 01887-2179
Phone
(781) 333-5310
Fax
(781) 333-5310
NPI assigned
Jan 5, 2018
Last updated
Mar 22, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2018

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

Authorized official

Name
David Corcoran, BCBA
Title
Clinical Director
Phone
(978) 971-8449

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X 9 MA Primary

Addresses

Primary practice location

64H Concord St
Wilmington, MA 01887-2179

Mailing address

64H Concord St
Wilmington, MA 01887-2179
Phone (978) 971-8449

National Provider Directory

National Provider Directory

Locations

64H Concord St
Wilmington, MA 01887
Phone (781) 333-5310

Practitioners & affiliated clinicians

Practitioners 65

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 65

NPI Registry JSON

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

{
    "created_epoch": "1515110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521676800000",
    "number": "1265949754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64H CONCORD ST",
            "city": "WILMINGTON",
            "state": "MA",
            "postal_code": "018872179",
            "telephone_number": "978-971-8449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64H CONCORD ST",
            "city": "WILMINGTON",
            "state": "MA",
            "postal_code": "018872179",
            "telephone_number": "781-333-5310",
            "fax_number": "781-333-5310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUVO BEHAVIORAL HEALTH OF MASSACHUSETTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-05",
        "last_updated": "2018-03-22",
        "status": "A",
        "authorized_official_last_name": "CORCORAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "978-971-8449",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "MA",
            "license": "9",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2018; 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.