NPIMap

Organization Active NPI

Preventive Medicine Associates

Doing business as Malden Wellness Center

  • Addiction (Substance Use Disorder) Counselor
  • Malden, MA
National Provider Identifier
1447574710
Registry record updated Jun 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
PREVENTIVE MEDICINE ASSOCIATES
Doing business as
Malden Wellness Center
Practice address
388 Pleasant St
Ste 305
Malden, MA 02148-8143
Phone
(781) 333-5467
Fax
(781) 333-5465
NPI assigned
Mar 16, 2010
Last updated
Jun 23, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
PREVENTIVE MEDICINE ASSOCIATESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 23, 2010

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

Authorized official

Name
Ms. Mary J Delong, MM, RHIA
Title
Credentialing Manager
Phone
(413) 222-7711

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X Primary

Addresses

Primary practice location

388 Pleasant St
Ste 305
Malden, MA 02148-8143

Mailing address

388 Pleasant St
Ste 305
Malden, MA 02148-8143
Phone (781) 333-5467

Other names 1

  • Malden Wellness Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Vineyard Healthcare Assoc29 organizations share this tax ID, including this one
Part of
Vineyard Healthcare Assoc

Other organizations with this tax ID 28

Organizations that report the same tax identification number in the National Provider Directory.

View all 28

Locations

388 Pleasant St
Ste 305
Malden, MA 02148
Phone (781) 333-5467

NPI Registry JSON

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

{
    "created_epoch": "1268697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277251200000",
    "number": "1447574710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "388 PLEASANT ST",
            "address_2": "STE 305",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021488143",
            "telephone_number": "781-333-5467",
            "fax_number": "781-333-5465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "388 PLEASANT ST",
            "address_2": "STE 305",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021488143",
            "telephone_number": "781-333-5467",
            "fax_number": "781-333-5465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVENTIVE MEDICINE ASSOCIATES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PREVENTIVE MEDICINE ASSOCIATES",
        "enumeration_date": "2010-03-16",
        "last_updated": "2010-06-23",
        "status": "A",
        "authorized_official_last_name": "DELONG",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "413-222-7711",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MM, RHIA"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Malden Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Malden, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2010; 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.