NPIMap

Organization Active NPI

Northeast Behavioral Associates

  • Community/Behavioral Health Agency
  • Woburn, MA
National Provider Identifier
1750833349
Registry record updated Oct 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
NORTHEAST BEHAVIORAL ASSOCIATES
Practice address
1 Driftwood Dr
Woburn, MA 01801-1269
Phone
(781) 799-4823
NPI assigned
Oct 29, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2016

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

Authorized official

Name
Jacqulyne Santullo
Title
Monitor
Phone
(781) 799-4823

Specialties & licenses 1

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

Addresses

Primary practice location

1 Driftwood Dr
Woburn, MA 01801-1269

Mailing address

1 Driftwood Dr
Woburn, MA 01801-1269
Phone (781) 799-4823

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1477699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477699200000",
    "number": "1750833349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DRIFTWOOD DR",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018011269",
            "telephone_number": "781-799-4823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DRIFTWOOD DR",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018011269",
            "telephone_number": "781-799-4823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST BEHAVIORAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-29",
        "last_updated": "2016-10-29",
        "status": "A",
        "authorized_official_last_name": "SANTULLO",
        "authorized_official_first_name": "JACQULYNE",
        "authorized_official_title_or_position": "MONITOR",
        "authorized_official_telephone_number": "781-799-4823"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2016; 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.