NPIMap

Organization Active NPI

The Home for Little Wanderers

Doing business as Child and Family Counseling Center

  • Adolescent and Children Mental Health Clinic/Center
  • Roslindale, MA
National Provider Identifier
1710045364
Registry record updated May 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
License
4YYK Issued in MA
Legal business name
THE HOME FOR LITTLE WANDERERS
Doing business as
Child and Family Counseling Center
Practice address
780 American Legion Hwy
Roslindale, MA 02131-3908
Phone
(617) 469-8500
Fax
(617) 325-0353
NPI assigned
Dec 5, 2006
Last updated
May 16, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2019

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

Authorized official

Name
Mr. Thomas Durling
Title
Cfo
Phone
(617) 267-3700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X 4YYK MA Primary

Addresses

Primary practice location

780 American Legion Hwy
Roslindale, MA 02131-3908

Mailing address

10 Guest St
Boston, MA 02135-2066
Phone (617) 267-3700

Other identifiers 1

IdentifierTypeStateIssuer
1306294MedicaidMA

Other names 1

  • Child and Family Counseling Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190816001334 MA Part B Supplier - Clinic/Group Practice 9032446802 Receives reassigned benefits from 1 practitioner
Practice locations: Roslindale, MA

National Provider Directory

National Provider Directory
Tax ID family
The Home for Litlle Wanderers5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

10 Guest St
Brighton, MA 02135
Phone (617) 469-8500

Practitioners & affiliated clinicians

Practitioners 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557964800000",
    "number": "1710045364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 GUEST ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021352066",
            "telephone_number": "617-267-3700",
            "fax_number": "617-267-8142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 AMERICAN LEGION HWY",
            "city": "ROSLINDALE",
            "state": "MA",
            "postal_code": "021313908",
            "telephone_number": "617-469-8500",
            "fax_number": "617-325-0353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE HOME FOR LITTLE WANDERERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2019-05-16",
        "status": "A",
        "authorized_official_last_name": "DURLING",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "617-267-3700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "MA",
            "license": "4YYK",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306294",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Child and Family Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Child and Family Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roslindale, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.