Active NPI
Child and Family Support Services
- Community/Behavioral Health Agency
- Lynn, MA
National Provider Identifier
1841634870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- License
- 117238
- Legal business name
- CHILD AND FAMILY SUPPORT SERVICES
- Practice address
- 20 Central Ave Ste 507
Lynn, MA 01901-1201 - Phone
- (617) 320-2511
- NPI assigned
- Apr 21, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Betsy Ivelisse Bonilla, LICSW
- Title
- Clinical Director
- Phone
- (617) 320-2511
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | 117238 | MA | Primary |
Addresses
Primary practice location
20 Central Ave Ste 507
Lynn, MA 01901-1201
Mailing address
20 Central Ave Ste 507
Lynn, MA 01901-1201
National Provider Directory
National Provider DirectoryLocations
20 Central Ave
Ste 507
Lynn, MA 01901
Phone (617) 320-2511
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366502400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1366502400000",
"number": "1841634870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 CENTRAL AVE STE 507",
"city": "LYNN",
"state": "MA",
"postal_code": "019011201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 CENTRAL AVE STE 507",
"city": "LYNN",
"state": "MA",
"postal_code": "019011201",
"telephone_number": "617-320-2511"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHILD AND FAMILY SUPPORT SERVICES",
"organizational_subpart": "NO",
"enumeration_date": "2013-04-21",
"last_updated": "2013-04-21",
"status": "A",
"authorized_official_last_name": "BONILLA",
"authorized_official_first_name": "BETSY",
"authorized_official_middle_name": "IVELISSE",
"authorized_official_title_or_position": "CLINICAL DIRECTOR",
"authorized_official_telephone_number": "617-320-2511",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "LICSW"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "MA",
"license": "117238",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lynn, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.