Tori Kym Black

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Practice address

148 Warren St
Lowell, MA 01852-2208

Phone

(978) 452-1736

NPI assigned

Feb 24, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tori Kym Spear Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• South Bay Mental Health Center

  • Community/Behavioral Health Agency
  • Lowell, MA
  • NPI 1790092088
  NPD (past)

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

{
    "created_epoch": "1582502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1841824398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 BAY VIEW DR",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940701644",
            "telephone_number": "650-906-0145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 WARREN ST",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018522208",
            "telephone_number": "978-452-1736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "TORI",
        "middle_name": "KYM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-24",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "W258605720",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "6509060145",
            "affiliation": "N",
            "endpointDescription": "phone number",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "address",
            "address_1": "236 Bay View Dr",
            "city": "San Carlos",
            "state": "CA",
            "country_code": "US",
            "postal_code": "940701644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TORI",
            "last_name": "SPEAR",
            "middle_name": "KYM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Veronica H Birungi, RN
• Shannon I Bischoff, LCSW
• Mandra R Biscornet, LICSW
• Robert Bishop
• Ginta Bistras
• Cinamon J. Blair
• Laurie Jean Blair
• Sharlene Blake
• Sara Blanch
• Andrea Dawn Blanchard

• Community/Behavioral Health Agency in Lowell, MA
• Providers in Lowell, MA by specialty
• Community/Behavioral Health Agency in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; 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.