Thom Mystic Valley Early Intervention

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

8130 Issued in MA

Legal business name

THOM MYSTIC VALLEY EARLY INTERVENTION

Practice address

11 Columbia Rd
Wakefield, MA 01880

Phone

(978) 302-0802

NPI assigned

Mar 26, 2008

Last updated

Mar 26, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Patricia Ann McCarthy, OTR/LNPI 1407030091

Title

Occupational Therapist

Phone

(978) 302-0802

Specialties & licenses 1

Addresses

Tax ID family

Thom Marlboro Area Early Intervention2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Thom Marlboro Area Early Intervention

  • Early Intervention Provider Agency
  • Marlborough, MA
  • NPI 1871884148
  NPD tax ID

Practitioners 1

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.

• Patricia Ann McCarthy, OTR/L

  • Community Health Worker
  • Wakefield, MA
  • NPI 1407030091
  NPD (past) Authorized official

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

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206489600000",
    "number": "1710159116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 COLUMBIA RD",
            "address_2": "UNIT 4",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018803339",
            "telephone_number": "978-302-0802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 COLUMBIA RD",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "01880",
            "telephone_number": "978-302-0802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOM MYSTIC VALLEY EARLY INTERVENTION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-26",
        "last_updated": "2008-03-26",
        "status": "A",
        "authorized_official_last_name": "MCCARTHY",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "978-302-0802",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "MA",
            "license": "8130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Early Intervention Provider Agency in Wakefield, MA
• Providers in Wakefield, MA by specialty
• Early Intervention Provider Agency in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2008; 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.