NPIMap

Organization Active NPI

Wayside Youth and Family Support Network

  • Community/Behavioral Health Agency
  • Malden, MA
National Provider Identifier
1720130453
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
WAYSIDE YOUTH AND FAMILY SUPPORT NETWORK
Practice address
22 Pleasant St
Malden, MA 02148-5119
Phone
(781) 338-2640
Fax
(781) 338-2217
NPI assigned
Jan 16, 2007
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
Ms. Ali Sarah Weinberg, MA
Title
Homebase Clinician
Phone
(781) 338-2640

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

22 Pleasant St
Malden, MA 02148-5119

Mailing address

1730 Commonwealth Ave.
Unit 3
Brighton, MA 02467
Phone (617) 515-7309

National Provider Directory

National Provider Directory
Tax ID family
Wayside Youth and Family Support Network8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

22 Pleasant St
Malden, MA 02148
Phone (781) 338-2640

Practitioners & affiliated clinicians

Practitioners 6

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": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720130453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 COMMONWEALTH AVE.",
            "address_2": "UNIT 3",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "02467",
            "telephone_number": "617-515-7309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 PLEASANT ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021485119",
            "telephone_number": "781-338-2640",
            "fax_number": "781-338-2217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYSIDE YOUTH AND FAMILY SUPPORT NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "ALI",
        "authorized_official_middle_name": "SARAH",
        "authorized_official_title_or_position": "HOMEBASE CLINICIAN",
        "authorized_official_telephone_number": "781-338-2640",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malden, 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.