NPIMap

Organization Active NPI

Commonwealth of Masschusetts

Doing business as Department of Mental Health - Cambridge Somerville Office

  • Case Management Agency
  • Cambridge, MA
National Provider Identifier
1710004858
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
COMMONWEALTH OF MASSCHUSETTS
Doing business as
Department of Mental Health - Cambridge Somerville Office
Practice address
2400 Massachusetts Ave
Cambridge, MA 02140-1854
Phone
(617) 626-4800
Fax
(617) 497-6128
NPI assigned
Mar 23, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Tina Licciardello
Title
Site Director
Phone
(617) 626-4800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

2400 Massachusetts Ave
Cambridge, MA 02140-1854

Mailing address

2400 Massachusetts Ave
Cambridge, MA 02140-1854
Phone (617) 626-4800

Other identifiers 1

IdentifierTypeStateIssuer
1802151MedicaidMA

Other names 1

  • Department of Mental Health - Cambridge Somerville Office Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mass Mental Health Cent147 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

Subparts reporting this organization as parent 4

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710004858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 MASSACHUSETTS AVE",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021401854",
            "telephone_number": "617-626-4800",
            "fax_number": "617-497-6128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 MASSACHUSETTS AVE",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021401854",
            "telephone_number": "617-626-4800",
            "fax_number": "617-497-6128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH OF MASSCHUSETTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LICCIARDELLO",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "SITE DIRECTOR",
        "authorized_official_telephone_number": "617-626-4800"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1802151",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Department of Mental Health - Cambridge Somerville Office",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cambridge, MA

Sources for this page

  • 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.