SOUTH BAY MENTAL HEALTH CENTER, INC. (NPI# 1033294558) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033294558 |
| Entity Type | Organization |
| Organization Name | SOUTH BAY MENTAL HEALTH CENTER, INC. |
| Other Organization Name | SOUTH BAY COMMUNITY SERVICES |
| Practice Address |
1115 West Chestnut Street Suite 202 Brockton MA 02301 |
| Practice Telephone | 5085212200 |
| Practice Fax Number | 5085842227 |
| Mailing Telephone | 5085212200 |
| Mailing Fax Number | 5085842227 |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2019-04-01 |
| Authorized Official Name | SARA J HART (PRESIDENT/COO) |
| Authorized Official Telephone | 5083240328 |
| Authorized Official Credential | LMHC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
4222 | MA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 1803395 | 05 | |
| MA | 1803514 | 05 | |
| MA | 1803034 | 05 |
| Other Name | Type Code |
|---|---|
| South Bay Community Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023096864 | South Bay Mental Health Center, Inc. | Clinic/Center | 1115 West Chestnut Street, Suite 202, Brockton, MA 02301 | 2006-01-03 |
| 1750703062 | South Bay Mental Health Center, Inc. | Early Intervention Provider Agency | 1115 West Chestnut Street, Suite 202, Brockton, MA 02301 | 2014-01-07 |
| 1326376195 | South Bay Mental Health Center, Inc. | Community/Behavioral Health | 50 Aldrin Rd, Plymouth, MA 02360-4827 | 2009-12-05 |
| 1760560650 | South Bay Mental Health Center, Inc. | Clinic/Center | 37 Belmont St, Brockton, MA 02301-5299 | 2006-11-01 |
| 1679651566 | South Bay Mental Health Center, Inc. | Clinic/Center | 37 Belmont St, Brockton, MA 02301-5299 | 2006-11-01 |
| 1568540458 | South Bay Mental Health Center, Inc. | Clinic/Center | 37 Belmont St, Brockton, MA 02301-5299 | 2006-11-01 |
| 1477631364 | South Bay Mental Health Center, Inc. | Clinic/Center | 37 Belmont St, Brockton, MA 02301-5299 | 2006-11-01 |
| 1497830905 | South Bay Mental Health Center, Inc. | Clinic/Center | 37 Belmont St, Brockton, MA 02301-5299 | 2006-10-25 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | SOUTH BAY MENTAL HEALTH CENTER, INC. | 1115 West Chestnut Street, Brockton, MA 02301 |
| Connecticut Business Registrations | SOUTH BAY MENTAL HEALTH CENTER, INC. | 1115 West Chestnut St, Brockton, MA 02301 |
| Street Address |
1115 WEST CHESTNUT STREET SUITE 202 |
| City | BROCKTON |
| State | MA |
| Zip Code | 02301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942807110 | Jenny Vulpis | Recreation Therapist | 940 Belmont St (br 135), Brockton, MA 02301 | 2020-10-01 |
| 1205444924 | Caroline Storey | Counselor | Men's Addiction Treatment Center, 10 Meadowbrook Road, Brockton, MA 02301 | 2020-07-20 |
| 1013546852 | Nuria Dos Santos Veiga | Occupational Therapist | 73 Denton St, Brockton, MA 02301 | 2020-04-03 |
| 1679113930 | Laura Ann Brondyk II | Counselor | 10 Christys Dr, Brockton, MA 02301 | 2020-01-14 |
| 1437796521 | Andrea Lopes | Developmental Therapist | 7 Goddard Road, Brockton, MA 02301 | 2019-12-08 |
| 1518420124 | Diligencehealthcare | Psychiatry & Neurology | 30-40 Westpark Street, Brockton, MA 02301 | 2019-04-10 |
| 1124530373 | Rachel Theys | Behavioral Analyst | 130 Liberty St Ste 13a, Brockton, MA 02301 | 2017-10-27 |
| 1689193369 | Anderson D Delgado | Behavior Technician | 11 Packard Way, Brockton, MA 02301 | 2017-09-14 |
| 1811415326 | Francesca Lavecchia | Clinical Neuropsychologist | Brockto Area Multi Service, Inc. 10 Christy Dr., Brockton, MA 02301 | 2017-09-05 |
| 1831615343 | Donna Marie Dugan | Counselor | South Bay Community Services, 340 Main Street - Suite 818, Worcester, MA 02301 | 2017-08-16 |
| Find all providers in zip 02301 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386167666 | Karrah A Norris | Clinic/Center | 10 Medowbrook Rd, Brockton, MA 02301 | 2017-07-19 |
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| 1265050280 | Neuropsychological Evaluations of Northampton | Clinic/Center | 71 King St Apt 1, Northampton, MA 01060-3276 | 2020-07-07 |
| 1982225835 | Let It Shine, LLC | Clinic/Center | 5 Market Sq Ste 203a, Amesbury, MA 01913-2426 | 2020-05-01 |
| 1396381539 | Omar Thompson Oral Thompson | Clinic/Center | 20 Goodale Rd Apt 2, Boston, MA 02126-1788 | 2019-11-22 |
| 1134778145 | Schnitzer Associates, Incorporated | Clinic/Center | 127 Concord Ave, Lexington, MA 02421-8203 | 2019-09-11 |
| 1942868781 | Wellness Empowerment | Clinic/Center | 10 New Driftway Ste 302, Scituate, MA 02066-4546 | 2019-06-05 |
| 1366009672 | Learning Curve Assessment Center | Clinic/Center | 559 Foundry St, South Easton, MA 02375-1357 | 2019-05-22 |
| 1285198432 | Perry Psychiatry, LLC | Clinic/Center | 2 Narrows Rd Bldg C, Westminster, MA 01473-1677 | 2019-01-22 |
| 1730659368 | Boston Family Therapy & Wellness Pllc | Clinic/Center | 1330 Beacon Street Suite 263, Brookline, MA 02446 | 2018-11-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.