Eliot Community Human Services
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Concord, MA
NPI 1679648182 · NPPES record last updated Jul 24, 2019
Key facts
- NPI
- 1679648182
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- License
- 4113 (MA)
- Legal business name
- ELIOT COMMUNITY HUMAN SERVICES
- Practice address
- 86 Baker Ave Ext
Concord, MA 01742 - Phone
- (978) 369-1113
- Fax
- (978) 369-0908
- NPI assigned
- Nov 21, 2006
- Organization subpart
- No
Authorized official
- Name
- Kate Markarian
- Title
- Ceo
- Phone
- (781) 861-0890
Other NPIs on the same Medicare enrollment 1
Corporate family (same tax ID) 19
Member organizations 1
Practitioners 224
-
Jonathan Acquaviva, M.ED, LMHC
-
Sara Gordon Belmont, LCSW
-
Jordan Bodwell, LMHC
-
Pamela A Bradbury, LMHC
-
Linda Ann Brown, LICSW, CADAC, LADC1
-
Lynne Marie Butler, RN, LMHC
-
Joseph Connors, LCSW
-
German V Crisostomo, M.D.
-
Sheila Mary Danaher, M. ED.
-
Febe Simone Dancier, LICSW
-
Michelle Danforth, PMHNP-BC
-
Morgan Taylor Doherty, PMHNP, MSN, RN
-
Anne Eden Evins, MD
-
Wendy Fay Gillenson, LICSW
-
Erich Goetzel, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040909001199 | MA | Part B Supplier - Clinic/Group Practice | 2062488000 |
Receives reassigned benefits from 167 practitioners 1 other NPI on this enrollment Practice locations: Concord, MA; Danvers, MA; Everett, MA; Haverhill, MA; Lowell, MA; Lynn, MA; Malden, MA |
National Provider Directory
- Tax ID family
- Eliot Community Health
Locations
111 Ornac
Concord, MA 01742
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | 4113 | MA | Yes |
Addresses
Primary practice location
86 Baker Ave Ext
Concord, MA 01742
Mailing address
125 Hartwell Ave
Lexington, MA 02421-3100
Phone (781) 861-0890
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1300911 | Medicaid | MA | |
| M18603 | Other | MA | BCBS OF MA |
| 1005555 | Other | MA | BEACON HEALTH STRATEGIES |
Other names
- Eliot Center
Other providers in Concord, MA
- Neale I Eckstein
- Joseph Eddy
- Dorothy Eisenhaure
- Audrey Eisenmenger-Kaufman
- David Marchant Eldridge
- Elite Care Therapeutics, LLC
- Elizabeth T. Maurer, LMHC LLC
- Sara Elkerm
- Julia Wade Elliott
- Emerson Anesthesia Associates P C
All providers in Concord, MA · Mental Health Clinic/Center (Including Community Mental Health Center) in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 24, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.