NPIMap

Organization Active NPI

Bay State Counseling Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brockton, MA
National Provider Identifier
1386923720
Registry record updated Aug 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
BAY STATE COUNSELING SERVICES, INC.
Practice address
1717 Main St
R
Brockton, MA 02301-7134
Phone
(508) 857-1466
Fax
(508) 857-1725
NPI assigned
Aug 16, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2011

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

Authorized official

Name
Dr. Yanants Antonevich, MD
Title
Director
Phone
(508) 857-1466

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

1717 Main St
R
Brockton, MA 02301-7134

Mailing address

1717-R Main Street
Brockton, MA 02301-7134
Phone (508) 857-1466

National Provider Directory

National Provider Directory

Locations

1717 Main St
#R
Brockton, MA 02301
Phone (508) 857-1466

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1313452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313452800000",
    "number": "1386923720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717-R MAIN STREET",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023017134",
            "telephone_number": "508-857-1466",
            "fax_number": "508-857-1725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 MAIN ST",
            "address_2": "R",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023017134",
            "telephone_number": "508-857-1466",
            "fax_number": "508-857-1725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY STATE COUNSELING SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-16",
        "last_updated": "2011-08-16",
        "status": "A",
        "authorized_official_last_name": "ANTONEVICH",
        "authorized_official_first_name": "YANANTS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "508-857-1466",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2011; 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.