Marvin Behavioral Health Ma PC
Organization Active NPI Psychologist · Boston, MA
NPI 1740860428 · NPPES record last updated Aug 31, 2022
Key facts
- NPI
- 1740860428
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychologist 103T00000X
- Legal business name
- MARVIN BEHAVIORAL HEALTH MA PC
- Practice address
- 177 Huntington Ave
Boston, MA 02115-3134 - Phone
- (610) 937-2023
- NPI assigned
- Apr 8, 2021
- Organization subpart
- No
Authorized official
- Name
- Aparna Atluru, MD
- Title
- President
- Phone
- (713) 818-8133
Practitioners 196
-
Amanda L Berriault, MA, LMHC
-
Jennifer G Gearhart, LICSW
-
David Mancuso, MSW
-
Martha Scott, LCSW
-
Laurence James Stybel, ED.D.
-
Kerri A Wike-Hallab, LMHC, DBH
-
Kelly J. Ace, MS, PHD
-
April Adams Edwards, MA, LPC
-
Marvin Cain Alexander, PHD, LICSW
-
Erika Altobelli, LCSW
-
Portia Marie Anderson I, LMFT
-
Renee I Anderson, PH.D., LPCC, LPC
-
Natalie Ankilewitz, LPC
-
Elizabeth Antonio, CLINICAL SOCIAL
-
Rebecca Armstrong, LMFT
-
Waded Baquerizo Mahuad, M.A.
-
Kavoos Ghane Bassiri, LMFT, LPCC
-
Amy R. Beck, PH.D.
-
Katherine Smeaton Beck, M.ED, LPC
National Provider Directory
Locations
1613 Chelsea Rd
San Marino, CA 91108
Phone (470) 782-3001
6595 Roswell Rd
Ste G3080
Sandy Springs, GA 30328
180 Talmadge Rd
Ste 223
Edison, NJ 08817
2929 Walnut St
Philadelphia, PA 19104
Phone (617) 249-6854
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor |
101YM0800X | |||
| Psychologist |
103T00000X | Yes | ||
| Clinical Social Worker |
1041C0700X | |||
| Marriage & Family Therapist |
106H00000X | |||
| Psychiatry Physician |
2084P0800X |
Addresses
Primary practice location
177 Huntington Ave
Boston, MA 02115-3134
Mailing address
4136 Del Rey Ave Ste 626
Marina del Rey, CA 90292-5604
Other practice location 1
4136 Del Rey Ave Ste 626
Marina Del Rey, CA 90292-5604
Phone (617) 249-6854
Other practice location 2
4136 Del Rey Ave Ste 626
Marina Del Rey, CA 90292-5604
Phone (617) 249-6854
Other practice location 3
2929 Walnut St
Philadelphia, PA 19104-5054
Phone (617) 249-6854
Other practice location 4
300 Deschutes Way SW Ste 208
Tumwater, WA 98501-7719
Phone (617) 249-6854
NPI Registry JSON
{
"created_epoch": "1617840000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1661904000000",
"number": "1740860428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4136 DEL REY AVE STE 626",
"city": "MARINA DEL REY",
"state": "CA",
"postal_code": "902925604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "177 HUNTINGTON AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "021153134",
"telephone_number": "610-937-2023"
}
],
"practiceLocations": [
{
"address_1": "4136 Del Rey Ave Ste 626",
"address_purpose": "LOCATION",
"city": "Marina Del Rey",
"state": "CA",
"postal_code": "902925604",
"country_code": "US",
"telephone_number": "617-249-6854",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4136 Del Rey Ave Ste 626",
"address_purpose": "LOCATION",
"city": "Marina Del Rey",
"state": "CA",
"postal_code": "902925604",
"country_code": "US",
"telephone_number": "617-249-6854",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2929 Walnut St",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191045054",
"country_code": "US",
"telephone_number": "617-249-6854",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "300 Deschutes Way SW Ste 208",
"address_purpose": "LOCATION",
"city": "Tumwater",
"state": "WA",
"postal_code": "985017719",
"country_code": "US",
"telephone_number": "617-249-6854",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "MARVIN BEHAVIORAL HEALTH MA PC",
"organizational_subpart": "NO",
"enumeration_date": "2021-04-08",
"last_updated": "2022-08-31",
"certification_date": "2022-08-02",
"status": "A",
"authorized_official_last_name": "ATLURU",
"authorized_official_first_name": "APARNA",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "713-818-8133",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 31, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.