Eliot Community Human Services
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Lexington, MA
NPI 1932271632 · NPPES record last updated Jul 30, 2019
Key facts
- NPI
- 1932271632
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- License
- 4321 (MA)
- Legal business name
- ELIOT COMMUNITY HUMAN SERVICES
- Practice address
- 125 Hartwell Ave
Lexington, MA 02421 - Phone
- (781) 861-0890
- Fax
- (781) 861-0899
- NPI assigned
- Nov 15, 2006
- Organization subpart
- No
Authorized official
- Name
- Kate Markarian
- Title
- Ceo
- Phone
- (781) 861-0890
Other NPIs on the same Medicare enrollment 1
Corporate family (same tax ID) 19
Practitioners 184
-
Jonathan Acquaviva, M.ED, LMHC
-
Christopher V Bang, LICSW
-
Olivia Beane, LCSW
-
Sara Gordon Belmont, LCSW
-
Jordan Bodwell, LMHC
-
James G Bouras, PMHNP-BC
-
Ruby Leah Boyd, MD
-
Pamela A Bradbury, LMHC
-
Linda Ann Brown, LICSW, CADAC, LADC1
-
Nicole Ann Brown, OTR, NP-C
-
Lee Bulgin, M.D.
-
Lynne Marie Butler, RN, LMHC
-
Elizabeth E Carleton, PMHNP-BC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040909001199 | MA | Part B Supplier - Clinic/Group Practice | 2062488000 |
Receives reassigned benefits from 167 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Concord, MA; Danvers, MA; Everett, MA; Haverhill, MA; Lowell, MA; Lynn, MA; Malden, MA |
National Provider Directory
- Tax ID family
- Eliot Community Health
Locations
86 Baker Avenue Ext
Ste 100
Concord, MA 01742
Phone (978) 202-4156
173 Chelsea St
Everett, MA 02149
Phone (617) 397-2020
43 Dartmouth St
Malden, MA 02148
Phone (781) 306-4820
52 Sharon St
Malden, MA 02148
Phone (781) 338-8800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | 4321 | MA | Yes |
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | 0730 | MA |
Addresses
Primary practice location
125 Hartwell Ave
Lexington, MA 02421
Mailing address
125 Hartwell Ave
Lexington, MA 02421-3100
Phone (781) 861-0890
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0009253 | Other | MA | NEIGHBORHOOD HEALTH PLAN |
| 1304852 | Medicaid | MA | |
| 260000472 | Other | MA | TRAVERLERS INS. RR-MEDICA |
| 702286 | Other | MA | TUFTS ASSOC. HEALTH |
| EI0M35 | Other | MA | BAYSTATE HEALTH EI |
| 1003010 | Other | MA | MH NHP BEACON HEALTH |
| 1307908 | Medicaid | MA | |
| 84645 | Other | MA | US HEALTH CARE |
| EI0032 | Other | MA | EI BCBSMA |
| 1300873 | Medicaid | MA | |
| 1310275 | Medicaid | MA | |
| 1800809 | Medicaid | MA | |
| FS2030290 | Other | MA | ADMINISTAR DEFENSE SERVIC |
| 286694 | Other | MA | MERIT BEHAVIORAL CARE |
| TRI2223002641 | Other | MA | BCBSMA |
| 601959 | Other | MA | HARVARD PILGRIM HEALTH |
Other names
- Tri-City Mental Health and Retardation Center
Other providers in Lexington, MA
- Ryan Eitner
- Yaman Zorlu Eksioglu
- Eliot Community Human Services
- Eliot Community Human Services
- Eliot Community Human Services
- Eliot Community Human Services
- Eliot Community Human Services, Inc.
- Eliot Community Human Services, Inc.
- Barry Steven Elkin
- Eleanor Gardner Elkin
All providers in Lexington, MA · Mental Health Clinic/Center (Including Community Mental Health Center) in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 30, 2019. 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.