Family and Community Resources, Inc.
Organization Active NPI Community/Behavioral Health Agency · Brockton, MA
NPI 1821159880 · NPPES record last updated Feb 10, 2020
Key facts
- NPI
- 1821159880
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- License
- 4695 DPH (MA)
- Legal business name
- FAMILY AND COMMUNITY RESOURCES, INC.
- Practice address
- 18 Newton St
Brockton, MA 02301-5115 - Phone
- (508) 583-6498
- Fax
- (508) 583-3775
- NPI assigned
- Dec 13, 2006
- Organization subpart
- No
Authorized official
- Name
- Claudette Kelly
- Title
- Billing Director
- Phone
- (508) 583-6498
Practitioners 28
-
Melissa Gardner, CNP
-
Erika Christon, MSW
-
Abigail Martin, LICSW
-
Samantha McCormick, MSW
-
Janis Oliveira, LCSW
-
Randi Alarid, MSW
-
Denise Boisvert, NP
-
Mary S Callahan, L.I.C.S.W.
-
Lauren B Enos, LCSW
-
Djemima Fleury, LICSW
-
Amy Patricia Goffredo, LCSW
-
Brenda Jean Korch, LICSW
-
Kerri Ellen Pelton, LCSW
-
Debra A Scott, LICSW
-
Suzanne Rowe Wilson, LICSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040429000980 | MA | Part B Supplier - Clinic/Group Practice | 2860489960 |
Receives reassigned benefits from 2 practitioners Practice locations: Brockton, MA |
National Provider Directory
Locations
9 Belmont St
Brockton, MA 02301
Phone (508) 583-6498
18 Newton St
Brockton, MA 02301
Phone (508) 583-5498
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | 4695 DPH | MA | Yes |
Addresses
Primary practice location
18 Newton St
Brockton, MA 02301-5115
Mailing address
18 Newton St
Brockton, MA 02301-5115
Phone (508) 583-6498
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1302981 | Other | MD | MBHP ID # |
| 95074701 | Other | MA | NETWORK HEALTH |
| 1302981 | Medicaid | MA | |
| 725287 | Other | MA | TUFTS ID NUMBER |
| M18532 | Other | MA | BCBS ID NUMBER |
| 1003790 | Other | MA | BEACON HEALTH ID # |
Other providers in Brockton, MA
- Amelia Falavinha
- Thalia Falcon
- Kensie Faldoski
- Garrey Thomas Faller
- Kara Lyn Falvey
- Family Preservation Center, Inc.
- Family Rehab Clinic
- Jerry CHI Chuan Fang
- Amy Fanning
- Jennifer C Farley
All providers in Brockton, MA · Community/Behavioral Health Agency in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 10, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.