NPIMap

Organization Active NPI

Wediko Children'S Services

  • Mental Health Counselor
  • Boston, MA
National Provider Identifier
1982838751
Registry record updated Jun 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
WEDIKO CHILDREN'S SERVICES
Practice address
72 E Dedham St
Boston, MA 02118-2315
Phone
(617) 292-9200
Fax
(617) 292-9272
NPI assigned
May 8, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2015

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

Authorized official

Name
Mr. Michael Clontz, MSW
Title
Program Director
Phone
(617) 292-9200

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary
Clinical Child & Adolescent PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC2200X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X

Addresses

Primary practice location

72 E Dedham St
Boston, MA 02118-2315

Mailing address

72 E Dedham St
Boston, MA 02118-2315
Phone (617) 292-9200

National Provider Directory

National Provider Directory
Tax ID family
Wediko Children'S Services5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1241740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433721600000",
    "number": "1982838751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 E DEDHAM ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182315",
            "telephone_number": "617-292-9200",
            "fax_number": "617-292-9272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 E DEDHAM ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182315",
            "telephone_number": "617-292-9200",
            "fax_number": "617-292-9272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEDIKO CHILDREN'S SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-08",
        "last_updated": "2015-06-08",
        "status": "A",
        "authorized_official_last_name": "CLONTZ",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "617-292-9200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; 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.