NPIMap

Organization Active NPI

Friends of the Shattuck Shelter

  • Addiction (Substance Use Disorder) Counselor
  • Jamaica Plain, MA
National Provider Identifier
1497897250
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
0796 Issued in MA
Legal business name
FRIENDS OF THE SHATTUCK SHELTER
Practice address
170 Morton St
Jamaica Plain, MA 02130-3735
Phone
(617) 983-0351
Fax
(617) 971-9339
NPI assigned
Feb 12, 2007
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
Mrs. Deborah Putnam, MPH, MSW
Title
Director of Program Development
Phone
(617) 983-0351

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 0796 MA Primary

Addresses

Primary practice location

170 Morton St
Jamaica Plain, MA 02130-3735

Mailing address

170 Morton St
Jamaica Plain, MA 02130-3735
Phone (617) 983-0351

Other identifiers 4

IdentifierTypeStateIssuer
1302311MedicaidMA
000000020458OtherMABMC HEALTHNET
1028790OtherMABEACON HEALTH STRATEGIES
1302311OtherMAVALUE OPTIONS (MBHP)

National Provider Directory

National Provider Directory
Tax ID family
Hopefound3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497897250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 MORTON ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021303735",
            "telephone_number": "617-983-0351",
            "fax_number": "617-971-9339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 MORTON ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021303735",
            "telephone_number": "617-983-0351",
            "fax_number": "617-971-9339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRIENDS OF THE SHATTUCK SHELTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PUTNAM",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "DIRECTOR OF PROGRAM DEVELOPMENT",
        "authorized_official_telephone_number": "617-983-0351",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MPH, MSW"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "0796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1302311",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BMC HEALTHNET",
            "identifier": "000000020458",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEACON HEALTH STRATEGIES",
            "identifier": "1028790",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS (MBHP)",
            "identifier": "1302311",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica Plain, 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.