RUSSELL JEREMY GWILLIAM (NPI# 1346557543) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1346557543 |
Entity Type | Individual |
Full Name | RUSSELL JEREMY GWILLIAM |
Credential | MA, LMHC |
Practice Address |
44 Front St Worcester MA 01608-1733 |
Mailing Address |
12 Pineview Trl Auburn MA 01501-2120 |
Practice Telephone | 5087530321 |
Mailing Telephone | 5088640839 |
Enumeration Date | 2010-09-09 |
Last Update Date | 2010-09-09 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 251S00000X | Community/Behavioral Health | 1745 | MA | Agencies |
Street Address |
44 FRONT ST |
City | WORCESTER |
State | MA |
Zip Code | 01608-1733 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649344821 | Henry Lee Willis Community Center, Inc | Clinic/Center | 44 Front St, Suite 480, Worcester, MA 01608-1733 | 2006-11-20 |
1316385214 | Andrey Mazo Dmd PC | Dentist | 44 Front St, Worcester, MA 01608-1733 | 2013-06-13 |
1528313467 | Lindsey A Vaughan | Counselor | 44 Front St, Suite 490, Worcester, MA 01608-1733 | 2012-07-17 |
1952656886 | Kaitlin Frances Bailey | Counselor | 44 Front St, Suite 490, Worcester, MA 01608-1733 | 2012-07-17 |
1023372695 | Thomas J Russell | Counselor | 44 Front St, Suite 490, Worcester, MA 01608-1733 | 2012-06-28 |
1780978916 | Kelly Ann Chomes | Counselor | 44 Front St, Suite 490, Worcester, MA 01608-1733 | 2011-06-06 |
1578872800 | Stephen Ludy | Counselor | 44 Front St, Suite 490, Worcester, MA 01608-1733 | 2010-10-05 |
1548579121 | Willis Center | Substance Abuse Rehabilitation Facility | 44 Front St, Fourth Floor, Worcester, MA 01608-1733 | 2010-09-30 |
1053629360 | Dana Mark Bergman | Counselor | 44 Front St, Suite 490, Worcester, MA 01608-1733 | 2010-09-21 |
1174831358 | Wills Center | Community/Behavioral Health | 44 Front St, 4th Floor, Worcester, MA 01608-1733 | 2010-09-21 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033721733 | Rebecca Smith Morgan | Physical Therapist | Easter Seals Massachusetts, 484 Main St, Worcester, MA 01608 | 2020-08-24 |
1083244057 | Marc Labb | Counselor | 25 Union St 3rd Floor, Worcester, MA 01608 | 2020-01-18 |
1154974145 | Shanil Shah | Student in an Organized Health Care Education/Training Program | St Vincent Hospital, Department of Internal Medicine, 123 Summer Street, Worcester, MA 01608 | 2019-07-19 |
1194377069 | Varun Kommalapati | Student in an Organized Health Care Education/Training Program | St Vincent Hospital, 123 Summer Street, Worcester, MA 01608 | 2019-07-11 |
1992361182 | Jenna Recko | Physical Therapy Assistant | Easter Seals of Massachusetts, 484 Main St, Worcester, MA 01608 | 2019-05-14 |
1619452646 | Kara Thompson | Registered Nurse | 100 Martin Luther King Jr Blvd, Worcester, MA 01608 | 2018-09-25 |
1427555325 | Baran Umut Vardar | Student in an Organized Health Care Education/Training Program | 123 Summer Street, Saint Vincent Hospital Radiology Dep, Worcester, MA 01608 | 2018-04-09 |
1609380765 | Mary Elizabeth O'donnell | Occupational Therapist | Easter Seals Ma, 484 Main Street, Worcester, MA 01608 | 2017-11-28 |
1093227316 | Oasis Home Care, LLC | Home Health | 340 Main St Ste 803, Worcester, MA 01608 | 2017-10-26 |
1912437500 | Peter A Rondon | Social Worker | 11 Sycamore Street, Worcester, MA 01608 | 2017-06-15 |
Find all providers in zip 01608 |
Taxonomy Code | 251S00000X |
Grouping | Agencies |
Classification | Community/Behavioral Health |
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275132458 | Autism Behavioral & Therapeutic Services | Community/Behavioral Health | 5 Bedford Ave, Worcester, MA 01604-4707 | 2020-10-20 |
1811502966 | R.e.s.t. Counseling Services, LLC | Community/Behavioral Health | 36 Tirrell St # 1, Worcester, MA 01603-2617 | 2020-09-14 |
1841820313 | On Watch Counseling Services | Community/Behavioral Health | 316 Plantation St, Worcester, MA 01604-1745 | 2020-01-23 |
1194389304 | Autism Therapy & Training Services | Community/Behavioral Health | 1 Longwood Ave, Worcester, MA 01606-3416 | 2019-04-24 |
1265909360 | Autism Health Services LLC | Community/Behavioral Health | 5 Nathaniel St, Worcester, MA 01604-1524 | 2018-10-26 |
1144733056 | Tamami Amara Okano | Community/Behavioral Health | 500 Massasoit Rd # 2, Worcester, MA 01604-3548 | 2017-11-14 |
1346794831 | Abiworcester, LLC | Community/Behavioral Health | 133 Puritan Ave, Worcester, MA 01604-3230 | 2016-08-12 |
1730553124 | H.r.i. Clinics Inc - (worcester Location) | Community/Behavioral Health | 411 Chandler St., Arbour Counseling Services Partial Hospital Lization Pr, Worcester, MA 01602 | 2015-11-23 |
1811389901 | Autism Intervention Center | Community/Behavioral Health | 2 Naumaan Ln, Worcester, MA 01606-1274 | 2015-02-26 |
1851780316 | Families Together LLC | Community/Behavioral Health | 120 Chandler St # 2l, Worcester, MA 01609-2923 | 2015-01-21 |
Find all providers in WORCESTER |
Please comment or provide details below to improve the information on RUSSELL JEREMY GWILLIAM.
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.