NPIMap

Organization Active NPI

Northeast Behavioral Associates

  • Mental Illness Community Based Residential Treatment Facility
  • Brockton, MA
National Provider Identifier
1639564214
Registry record updated Apr 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
NORTHEAST BEHAVIORAL ASSOCIATES
Practice address
23 Dailey Rd
Brockton, MA 02302-2250
Phone
(774) 240-1504
NPI assigned
Apr 1, 2015
Last updated
Apr 1, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2015

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

Authorized official

Name
Jayla C Hampton, M.EDNPI 1679224943
Title
Behavioral Management Therapist
Phone
(774) 240-1504

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
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

23 Dailey Rd
Brockton, MA 02302-2250

Mailing address

23 Dailey Rd
Brockton, MA 02302-2250
Phone (774) 240-1504

Other names 1

  • Northeast behavioral associates Former legal business name

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": "1427846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427846400000",
    "number": "1639564214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 DAILEY RD",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023022250",
            "telephone_number": "774-240-1504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 DAILEY RD",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023022250",
            "telephone_number": "774-240-1504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST BEHAVIORAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-01",
        "last_updated": "2015-04-01",
        "status": "A",
        "authorized_official_last_name": "HAMPTON",
        "authorized_official_first_name": "JAYLA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "BEHAVIORAL MANAGEMENT THERAPIST",
        "authorized_official_telephone_number": "774-240-1504",
        "authorized_official_credential": "M.ED"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northeast behavioral associates",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Apr 1, 2015; 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.