NPIMap

Organization Active NPI

Somerville Mental Health Association, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Somerville, MA
National Provider Identifier
1871765644
Registry record updated Apr 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
SOMERVILLE MENTAL HEALTH ASSOCIATION, INC.
Practice address
78 College Ave
Somerville, MA 02144-1916
Phone
(617) 629-6624
Fax
(617) 625-6339
NPI assigned
Apr 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2008

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

Authorized official

Name
Maritza E Jacobs
Title
Director of Managaement Services
Phone
(617) 629-5341

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X MA Primary

Addresses

Primary practice location

78 College Ave
Somerville, MA 02144-1916

Mailing address

167 Holland St
Room 133
Somerville, MA 02144
Phone (617) 625-0710

Other identifiers 1

IdentifierTypeStateIssuer
1305727MedicaidMA

National Provider Directory

National Provider Directory

Locations

167 Holland St
Rm 133
Somerville, MA 02144
Phone (617) 625-0710

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207008000000",
    "number": "1871765644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 HOLLAND ST",
            "address_2": "ROOM 133",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "02144",
            "telephone_number": "617-625-0710",
            "fax_number": "617-625-6339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 COLLEGE AVE",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021441916",
            "telephone_number": "617-629-6624",
            "fax_number": "617-625-6339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOMERVILLE MENTAL HEALTH ASSOCIATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-01",
        "last_updated": "2008-04-01",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "MARITZA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECTOR OF MANAGAEMENT SERVICES",
        "authorized_official_telephone_number": "617-629-5341"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1305727",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; 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.