NPIMap

Organization Active NPI

South Bay Mental Health Center, Inc.

  • Clinic/Center
  • Brockton, MA
National Provider Identifier
1497830905
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
4222 Issued in MA
Legal business name
SOUTH BAY MENTAL HEALTH CENTER, INC.
Practice address
37 Belmont St
Brockton, MA 02301-5299
Phone
(508) 580-4691
NPI assigned
Oct 25, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Peter Scanlon, PHDNPI 1881625309
Title
Executive Director
Phone
(508) 559-0473

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
Clinic/Center 261Q00000X 4222 MA Primary

Addresses

Primary practice location

37 Belmont St
Brockton, MA 02301-5299

Mailing address

37 Belmont St
Brockton, MA 02301-5299
Phone (508) 580-4691

Other identifiers 1

IdentifierTypeStateIssuer
CP0064OtherMANURSE SPECIALIST

National Provider Directory

National Provider Directory
Tax ID family
South Bay Mental Health18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

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": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497830905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 BELMONT ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015299",
            "telephone_number": "508-580-4691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 BELMONT ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015299",
            "telephone_number": "508-580-4691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BAY MENTAL HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCANLON",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "508-559-0473",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MA",
            "license": "4222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE SPECIALIST",
            "identifier": "CP0064",
            "state": "MA"
        }
    ],
    "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 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.