NPIMap

Organization Active NPI

The Key Program, Incorporated.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Springfield, MA
National Provider Identifier
1508908229
Registry record updated Jun 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
4389 Issued in MA
Legal business name
THE KEY PROGRAM, INCORPORATED.
Practice address
576 State St
Springfield, MA 01109-4104
Phone
(413) 781-6485
Fax
(413) 788-6925
NPI assigned
Feb 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2013

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

Authorized official

Name
Mr. William Lyttle
Title
President
Phone
(508) 877-3690

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 4389 MA Primary

Addresses

Primary practice location

576 State St
Springfield, MA 01109-4104

Mailing address

576 State St
Springfield, MA 01109-4104
Phone (413) 781-6485

Other identifiers 2

IdentifierTypeStateIssuer
M17759OtherMABLUE CROSS BLUE SHIELD
1306839MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040216000944 MA Part B Supplier - Clinic/Group Practice 1850286287 Receives reassigned benefits from 5 practitioners
Practice locations: Waltham, MA

National Provider Directory

National Provider Directory
Tax ID family
The Key Program Incorporated4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

77 Rumford Ave
Waltham, MA 02453
Phone (781) 894-4307

Practitioners & affiliated clinicians

Practitioners 49

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

View all 49

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": "1370995200000",
    "number": "1508908229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 STATE ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011094104",
            "telephone_number": "413-781-6485",
            "fax_number": "413-788-6925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "576 STATE ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011094104",
            "telephone_number": "413-781-6485",
            "fax_number": "413-788-6925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE KEY PROGRAM, INCORPORATED.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2013-06-12",
        "status": "A",
        "authorized_official_last_name": "LYTTLE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "508-877-3690",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MA",
            "license": "4389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "M17759",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306839",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.