NPIMap

Organization Active NPI

Summit Academy, Inc.

  • Behavior Analyst
  • Worcester, MA
National Provider Identifier
1649759770
Registry record updated Aug 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
SUMMIT ACADEMY, INC.
Practice address
15 Jamesbury Dr
Worcester, MA 01609-1201
Phone
(508) 751-8500
Fax
(508) 751-8501
NPI assigned
Aug 9, 2018
Organization subpart
Yes
Parent organization
SUMMIT ACADEMY, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 9, 2018

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

Authorized official

Name
Mr. Daniel James Dimezza
Title
Ceo/Executive Director
Phone
(508) 751-8500

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary
Assistant Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 106E00000X
Behavior TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 106S00000X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X

Addresses

Primary practice location

15 Jamesbury Dr
Worcester, MA 01609-1201

Mailing address

15 Jamesbury Dr
Worcester, MA 01609-1201
Phone (508) 751-8500

Other names 1

  • Summit Behavior Services Other name

National Provider Directory

National Provider Directory
Part of
Summit Academy Inc

Locations

15 Jamesbury Dr
Worcester, MA 01609
Phone (508) 751-8500

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1533772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533772800000",
    "number": "1649759770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 JAMESBURY DR",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016091201",
            "telephone_number": "508-751-8500",
            "fax_number": "508-751-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 JAMESBURY DR",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016091201",
            "telephone_number": "508-751-8500",
            "fax_number": "508-751-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT ACADEMY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUMMIT ACADEMY, INC.",
        "enumeration_date": "2018-08-09",
        "last_updated": "2018-08-09",
        "status": "A",
        "authorized_official_last_name": "DIMEZZA",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CEO/EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "508-751-8500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summit Behavior Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2018; 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.