Henry Lee Willis Community Center, Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

0690 Issued in MA

Legal business name

HENRY LEE WILLIS COMMUNITY CENTER, INC

Doing business as

The Willis Center

Practice address

44 Front St
Suite 480
Worcester, MA 01608-1733

Phone

(508) 799-2934

Fax

(508) 770-1732

NPI assigned

Nov 20, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Carlton A Watson

Title

President

Phone

(508) 799-0702

Specialties & licenses 1

Addresses

Other names 1

• The Willis Center Doing business as

Locations

Practitioners 1

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

• Jesse R Mellor, LADC

  • Addiction (Substance Use Disorder) Counselor
  • Worcester, MA
  • NPI 1275788663
  NPD (past)

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649344821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 FOREST ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016091529",
            "telephone_number": "508-799-0702",
            "fax_number": "508-754-0245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 FRONT ST",
            "address_2": "SUITE 480",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081733",
            "telephone_number": "508-799-2934",
            "fax_number": "508-770-1732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRY LEE WILLIS COMMUNITY CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "CARLTON",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "508-799-0702",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MA",
            "license": "0690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Willis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marilyn Ann Hennigan, LICSW
• Sharon M. Hennigan, NP
• Nils Henninger, M.D.
• Daniel Henrickson
• Emely Henriquez
• Curlisa Henry
• Renee Christianne Henry
• Richard Henry, M. ED.
• Sarah Henry, PA-C
• Alexandria Hensel-Werderitch

• Clinic/Center in Worcester, MA
• Providers in Worcester, MA by specialty
• Clinic/Center in Massachusetts

• 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.