Organization Active NPI

Child and Family Support Services

  • Community/Behavioral Health Agency
  • Lynn, MA
National Provider Identifier
1841634870
Registry record updated Apr 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
117238 Issued in MA
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

Updated by the provider on Apr 21, 2013

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)CodeLicenseStatePrimary
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 Directory

Locations

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.

Verify at the official NPI Registry.