TERESA PHELAN (NPI# 1275143646) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275143646 |
| Entity Type | Individual |
| Full Name | TERESA PHELAN |
| Practice Address |
Umass Memorial Medical Center 55 Lake Avenue North, Psychiatry Worcester MA 01655 |
| Practice Telephone | 5083341000 |
| Mailing Telephone | 5083341000 |
| Enumeration Date | 2020-07-31 |
| Last Update Date | 2020-07-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | 0148RC | MA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | RECOVERY COACH CERTIFICATION | 0148RC | 01 |
| Street Address |
UMASS MEMORIAL MEDICAL CENTER 55 LAKE AVENUE NORTH, PSYCHIATRY |
| City | WORCESTER |
| State | MA |
| Zip Code | 01655 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427082189 | David Dionne Mcmanus | Internal Medicine | Umass Memorial Medical Center, 55 Lake Ave North, Worcester, MA 01655 | 2006-07-10 |
| 1609438480 | Megan Ann Leary | Pharmacist | Umass Memorial Medical Center, 55 Lake Ave North, Worcester, MA 01655 | 2019-07-02 |
| 1104261429 | Harold W. Hsu | Student in an Organized Health Care Education/Training Program | Umass Memorial Medical Center, 55 Lake Ave N - General Surgery, Worcester, MA 01655 | 2013-04-30 |
| 1831483825 | John E Berry-candelario | Neurological Surgery | Umass Memorial Medical Center, 55 Lake Avenue North, Worcester, MA 01655-0002 | 2011-06-07 |
| 1275696965 | Donna Marie Belcher | Dietitian, Registered | Umass Memorial Medical Center, Nutrition Dept - 55 Lake Ave North, Worcester, MA 01655 | 2006-12-18 |
| 1235245663 | Andrew P Chen | Radiology | Umass Memorial Medical Center, 55 Lake Avenue North, Room S2-825, Worcester, MA 01655 | 2006-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205489713 | Darryl Sweeper Jr. | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Psychiatry, Umass Memorial Medical Center, Worcester, MA 01655 | 2019-07-23 |
| 1225690530 | Ryan Zenevitch | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Family Medicine, Umass Memorial Medical Center, Worcester, MA 01655 | 2019-07-08 |
| 1932688454 | Victoria Sayeg | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Pediatrics, Worcester, MA 01655 | 2018-08-07 |
| 1114425675 | Judith Dio Wentzell | Social Worker | Umassmemorial Medical Center, 55 Lake Ave North, Dept of Care Coordination, Worcester, MA 01655 | 2018-01-30 |
| 1861927386 | Muhammad Waqas Khan | Student in an Organized Health Care Education/Training Program | University of Massachusetts 55 North Lake Ave, Neurology, Worcester, MA 01655 | 2017-04-21 |
| 1861806192 | Qaiser Shamshir Khan | Psychiatry & Neurology | 55 Lake Ave N # S7-831, Worcester, MA 01655 | 2014-06-14 |
| 1073858981 | Heidi Glover | Nurse Practitioner | 55 Lake Ave North Dept. of Pedi-adolescent, Ummc University Campus, Worcester, MA 01655 | 2012-12-04 |
| 1972867992 | Anna Bjornsdottir | Psychiatry & Neurology | 55 Lake Av N, Worcester, MA 01655 | 2012-06-25 |
| 1245567676 | Steven Edward Mckinley | Nurse Practitioner | 55 Lake Ave. North, Umass Memorial Medical Center University Campus, Worcester, MA 01655 | 2009-11-05 |
| 1851582951 | Robin I Davidson | Neurological Surgery | 55 Lake Ave, North, Ummhc-univ Campus, Worcester, MA 01655 | 2007-08-05 |
| Find all providers in zip 01655 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366918724 | Coretta Mcgill | Peer Specialist | 12 Montague St, Worcester, MA 01603-3125 | 2018-10-23 |
| 1023586054 | Tamara Ann Buckley Leclerc | Peer Specialist | 29 E Mountain St, Worcester, MA 01606-1400 | 2018-11-07 |
| 1922493378 | Jennifer Oconnor | Peer Specialist | 26 Queen St, Worcester, MA 01610-2473 | 2015-04-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861010043 | Christopher Solomon | Peer Specialist | 8201 Inwood Dr, Woburn, MA 01801-5161 | 2020-07-14 |
| 1346878725 | Dynamicare Health | Peer Specialist | 288 Norfolk St Ste 4, Cambridge, MA 02139-1430 | 2020-03-31 |
| 1114553989 | Theresa Buccico | Peer Specialist | 284 Union Ave, Framingham, MA 01702-6318 | 2020-03-12 |
| 1235762741 | Peter Douglas Mantell IIi | Peer Specialist | 130 Millers Falls Rd, Turners Falls, MA 01376-2250 | 2020-02-13 |
| 1083259154 | Darlene Cruz | Peer Specialist | 5121 Crane Brook Way, Peabody, MA 01960-8526 | 2019-11-13 |
| 1700437571 | Edith Silva | Peer Specialist | 131 W Main St Ste 101, Orange, MA 01364-1157 | 2019-09-24 |
| 1225505720 | Stephanie Wamback | Peer Specialist | 20 Green St # 2, Dudley, MA 01571-3210 | 2018-11-01 |
| 1902380017 | Choice Recovery Coaching Inc. | Peer Specialist | 155 Maple St., Suite 305, Springfield, MA 01105 | 2018-09-24 |
| 1891219747 | Daniel Robert Proulx | Peer Specialist | 2 Endicott Ave, Marblehead, MA 01945-1617 | 2017-08-02 |
| 1093256133 | Bonnie J Peterson | Peer Specialist | 5 Wakefield Ave, Saugus, MA 01906-2711 | 2017-03-08 |
| 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.