MR. EARL DANDY JR.


Address: 15 Elmore St # 2, Roxbury, MA 02119-1618
Phone: 8572443474

MR. EARL DANDY JR. (NPI# 1215297304) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1215297304
Entity Type Individual
Full Name MR. EARL DANDY JR.
Credential LACD 1
Practice Address 15 Elmore St # 2
Roxbury
MA 02119-1618
Practice Telephone 8572443474
Mailing Telephone 8572443474
Enumeration Date 2012-05-22
Last Update Date 2013-10-21
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
Behavioral Health & Social Service Providers

Office Location

Street Address 15 ELMORE ST # 2
City ROXBURY
State MA
Zip Code 02119-1618

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1083089676 Natasha Cruz Counselor 263 Eustis Street, Roxbury, MA 02119 2015-12-08
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1922484799 Dina Ghaly-habib Student in an Organized Health Care Education/Training Program 100 East Newton St., G-706, Boston, MA 02119 2015-08-04
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Taxonomy Information

Taxonomy Code 101YA0400X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Addiction (Substance Use Disorder)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1104320357 Juan Grullon Counselor 302 Eustis St, Roxbury, MA 02119-3800 2018-03-22
1083089676 Natasha Cruz Counselor 263 Eustis Street, Roxbury, MA 02119 2015-12-08
1083046205 Christopher Conway Counselor 432 Dudley St Ste 211, Roxbury, MA 02119-2763 2013-07-30
1437385754 Alice Wood Griffin Counselor 28 Hemlock Rd, Roxbury, CT 06783-1409 2009-06-01
1861612053 Ameatriss Little Counselor 55 Topeka Street, Roxbury, MA 02215 2007-04-27
1184128050 Anna M Rodriguez Counselor 302 Eustis St, Roxbury, MA 02119-3800 2018-03-23
1104320365 Mary-alyssa E Nieman Counselor 302 Eustis St, Roxbury, MA 02119-3800 2018-03-22
1881198034 Jose O Colon Counselor 245 Eustis St, Roxbury, MA 02119-2826 2018-03-22
1922502186 Dina Park-matsas Counselor 302 Eustis St, Roxbury, MA 02119-3800 2018-03-22
1902300163 Felix Rivera Counselor 302 Eustis St, Roxbury, MA 02119-3800 2018-03-22
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Competitor

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City ROXBURY
Zip Code 02119

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Dataset Information

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.

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