Organization Active NPI

Mental Health Alcove PC

  • Psychiatric/Mental Health Nurse Practitioner
  • Woburn, MA
National Provider Identifier
1972243541
Registry record updated May 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MENTAL HEALTH ALCOVE PC
Practice address
500 W Cummings Park Ste 4500
Woburn, MA 01801-6617
Phone
(617) 794-8357
NPI assigned
Mar 31, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2022

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

Authorized official

Name
Marilyne Jones-JenkinsNPI 1043510423
Title
Owner
Phone
(339) 999-2794

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

500 W Cummings Park Ste 4500
Woburn, MA 01801-6617

Mailing address

500 W Cummings Park Ste 4500
Woburn, MA 01801-6617
Phone (339) 999-2794

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221013002203 MA Part B Supplier - Clinic/Group Practice 5799151965 Receives reassigned benefits from 1 practitioner
Practice locations: Woburn, MA

National Provider Directory

National Provider Directory

Locations

500 W Cummings Park
Ste 4500
Woburn, MA 01801
Phone (339) 999-2794

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1648684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653004800000",
    "number": "1972243541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W CUMMINGS PARK STE 4500",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018016617",
            "telephone_number": "339-999-2794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W CUMMINGS PARK STE 4500",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018016617",
            "telephone_number": "617-794-8357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL HEALTH ALCOVE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-31",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-20",
        "status": "A",
        "authorized_official_last_name": "JONES-JENKINS",
        "authorized_official_first_name": "MARILYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "339-999-2794"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.