THERESA MONAHAN SMITH (NPI# 1356672604) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356672604 |
| Entity Type | Individual |
| Full Name | THERESA MONAHAN SMITH |
| Other Name | THERESA D MONAHAN |
| Credential | RN, CNP |
| Practice Address |
177 Carroll Ave Brockton MA 02301-6315 |
| Practice Telephone | 5085105133 |
| Practice Fax Number | 5085839800 |
| Mailing Telephone | 5085105133 |
| Mailing Fax Number | 5085839800 |
| Enumeration Date | 2010-01-27 |
| Last Update Date | 2016-08-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
115563 | MA | Nursing Service Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
RN115563 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | MASS HEALTH | 11002802513 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467980052 | Theresa P Smith | Technician | 2301 11th St Nw Apt 116, Washington, DC 20001-2245 | 2017-05-26 |
| 1942651518 | Theresa Smith | Pediatrics | 5580 Celestial Dr, Atwater, CA 95301-3119 | 2016-06-24 |
| 1346516697 | Theresa Smith | Occupational Therapist | 33 Buttonwood Pl, Hazlet, NJ 07730-2173 | 2012-03-30 |
| 1801916283 | Theresa Faye Smith | Social Worker | 14 North Cottonwood Street, Woodland, AL 95695 | 2007-03-30 |
| 1841321486 | Theresa J Smith | Social Worker | 1119 S Elliott Ave, Aurora, MO 65605-2405 | 2007-03-07 |
| 1326119538 | Theresa Smith | Occupational Therapist | 7675 Phoenix Dr Apt 1025, Houston, TX 77030-4718 | 2006-11-10 |
| 1659312973 | Theresa Flynn Smith | Social Worker | 517 Tomahawk Ave, Black Mountain, NC 28711-2861 | 2006-06-09 |
| 1063476000 | Theresa L. Smith | Chiropractor | 122 E Walnut Ave, Suite C, Monrovia, CA 91016-3449 | 2006-04-14 |
| 1598366304 | Theresa Smith | Counselor | 239 W 9th St, Upland, CA 91786-5979 | 2020-11-06 |
| 1336755909 | Theresa Jean Smith | Technician | 87 Swierkos Dr, Moundsville, WV 26041-4209 | 2020-09-19 |
| Street Address |
177 CARROLL AVE |
| City | BROCKTON |
| State | MA |
| Zip Code | 02301-6315 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508362682 | Barbara Jean Balcius-sullivan | Licensed Practical Nurse | 177 Carroll Ave, Brockton, MA 02301-6315 | 2018-04-05 |
| 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 | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528694361 | Abigail Nganye | Nurse Practitioner | 88 Arthur St, Brockton, MA 02302-1803 | 2020-03-12 |
| 1922574946 | Jennifer Ann Livesley | Nurse Practitioner | 22 Christys Dr, Brockton, MA 02301-1839 | 2018-10-17 |
| 1871091553 | Care4us Wellness Center LLC | Nurse Practitioner | 17 Clarence St, Brockton, MA 02301-1607 | 2018-01-26 |
| 1700439536 | Ogo George | Nurse Practitioner | 529 Pearl St, Brockton, MA 02301-2825 | 2019-07-21 |
| 1568971547 | Sana Muqqadus | Nurse Practitioner | 680 Centre St, Brockton, MA 02302-3308 | 2017-09-22 |
| 1235654534 | Kevin Diguglielmo | Nurse Practitioner | 940 Belmont St, Brockton, MA 02301-5596 | 2017-08-08 |
| 1225551674 | Lorraine Wiley | Nurse Practitioner | 940 Belmont St, Brockton, MA 02301-5596 | 2017-07-18 |
| 1386198067 | Michelle Gibson | Nurse Practitioner | 940 Belmont St, Brockton, MA 02301-5596 | 2016-08-10 |
| 1003282286 | Rebecca Match | Nurse Practitioner | 20 Meadowbrook Rd, Brockton, MA 02301-7122 | 2015-08-11 |
| 1598168189 | Monahan Mental Health Group, PC | Nurse Practitioner | 820 Pearl St, Brockton, MA 02301-4411 | 2014-09-26 |
| Find all providers in BROCKTON | ||||
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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.