Mystic Valley Regional Charter School

Primary specialty

Local Education Agency (LEA)Taxonomy code 251300000X

Legal business name

MYSTIC VALLEY REGIONAL CHARTER SCHOOL

Practice address

770 Salem St
Malden, MA 02148-4415

Phone

(781) 388-0222

Fax

(781) 321-5688

NPI assigned

Mar 30, 2007

Organization subpart

No

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

Authorized official

Name

Kathy Kinnon

Title

Special Education Coordinator

Phone

(781) 388-0222

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1447370572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 SALEM ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021484415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 SALEM ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021484415",
            "telephone_number": "781-388-0222",
            "fax_number": "781-321-5688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYSTIC VALLEY REGIONAL CHARTER SCHOOL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KINNON",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "SPECIAL EDUCATION COORDINATOR",
        "authorized_official_telephone_number": "781-388-0222"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1955772",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaitlin Marie Murtha, RN
• Olena Kushnarenko Murthy, CNP
• Mystic Valley Elder Services
• Mystic Valley Elder Services, Inc.
• Mystic Valley Elder Services, Inc.
• Jhenya N Nahreini
• Brenda Senabulya Najjuma, REGISTERED NURSE
• Diana Claire Nalubega
• Peace Namyalo
• Abdulelah M Naqshabandi, M.D

• Local Education Agency (LEA) in Malden, MA
• Providers in Malden, MA by specialty
• Local Education Agency (LEA) in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.