NPIMap

Organization Active NPI

635 Community Health Collective

  • Clinical Social Worker
  • Jamaica Plain, MA
National Provider Identifier
1558074088
Registry record updated Dec 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
635 COMMUNITY HEALTH COLLECTIVE
Practice address
209 Wachusett St Apt 1
Jamaica Plain, MA 02130-4233
Phone
(801) 441-0176
NPI assigned
Dec 29, 2022
Last updated
Dec 29, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2022

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

Authorized official

Name
Dr. Eliot Bryant Sykes, LICSWNPI 1528531761
Title
Owner
Phone
(801) 824-1939

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

209 Wachusett St Apt 1
Jamaica Plain, MA 02130-4233

Mailing address

209 Wachusett St Apt 1
Jamaica Plain, MA 02130-4233

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address admin@635communityhealthcollective.com Direct

National Provider Directory

National Provider Directory

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": "1672272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672272000000",
    "number": "1558074088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 WACHUSETT ST APT 1",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021304233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 WACHUSETT ST APT 1",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021304233",
            "telephone_number": "801-441-0176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "635 COMMUNITY HEALTH COLLECTIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-29",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A",
        "authorized_official_last_name": "SYKES",
        "authorized_official_first_name": "ELIOT",
        "authorized_official_middle_name": "BRYANT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-824-1939",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@635communityhealthcollective.com",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "209 Wachusett St Apt 1",
            "city": "Jamaica Plain",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021304233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Dec 29, 2022; 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.