MYRTISE KRETSEDEMAS (NPI# 1871809111) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871809111 |
| Entity Type | Individual |
| Full Name | MYRTISE KRETSEDEMAS |
| Credential | LICSW |
| Practice Address |
181 Fairmount Ave Hyde Park MA 02136-3505 |
| Mailing Address |
867 Boylston St Fl 5 Boston MA 02116-2774 |
| Practice Telephone | 6172305210 |
| Mailing Telephone | 6173568242 |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2016-11-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
119089 | MA | Behavioral Health & Social Service Providers |
| Street Address |
181 FAIRMOUNT AVE |
| City | HYDE PARK |
| State | MA |
| Zip Code | 02136-3505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730448945 | Chinara Shani Smith | Social Worker | 181 Fairmount Ave, Hyde Park, MA 02136-3505 | 2012-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952892564 | Dionne Latrice | Counselor | 695 Truman Pwky, Boston, MA 02136 | 2018-05-21 |
| 1134622426 | Light House Behavioral Health and Wellness Center Inc. | Community/Behavioral Health | 1 Westinghouse Plaza, A-216, Boston, MA 02136 | 2018-03-13 |
| 1396168795 | Living Well | Home Health | 53 Oak St, Hyde Park, MA 02136 | 2014-01-22 |
| 1891051074 | Marie Ronique Yilain | Licensed Practical Nurse | 59 Cromwell Rd, Hyde Park, MA 02136 | 2012-04-02 |
| 1033410543 | Stephanie Sabrina Seigle | Counselor | 5 Linden Ave, Hyde Park, MA 02136 | 2010-11-15 |
| 1699075747 | Jeffrey Meisner | Physical Therapist | 188 Providence Street, Boston Pain Clinic, Hyde Park, MA 02136 | 2010-10-22 |
| 1356593743 | Supplemantal Health Care Services | Residential Treatment Facility, Physical Disabilities | 731 Truman Hwy, Hyde Park, MA 02136 | 2008-10-16 |
| 1407023047 | Amy Elizabeth Delaney | Nurse Practitioner | 695 Truman Parkway, Suite 203, Hyde Park Pediatrics, Hyde Park, MA 02136 | 2008-05-13 |
| 1629254263 | Alla Urman | Nurse Practitioner | 1274 Hyde Park Ave, Hyde Park, MA 02136 | 2008-01-14 |
| 1912106980 | Marina Williams | Counselor | 1158 Hyde Park Ave, Hyde Park, MA 02136 | 2007-07-11 |
| Find all providers in zip 02136 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346890035 | Emma Rosen | Social Worker | 612 Metropolitan Ave, Hyde Park, MA 02136-3122 | 2019-09-16 |
| 1841766094 | Louise Suzanne Tardif | Social Worker | 87 Sierra Rd Apt 20, Hyde Park, MA 02136-2521 | 2018-10-15 |
| 1467935361 | David Paul Kennedy | Social Worker | 22 Manion Rd, Hyde Park, MA 02136-3834 | 2018-09-07 |
| 1508343807 | Sarah Elizabeth Mclaughlin | Social Worker | 1530 River St, Hyde Park, MA 02136-1616 | 2018-07-19 |
| 1225540735 | Kira N Bettinger | Social Worker | 523 N 750 E, Hyde Park, UT 84318-3357 | 2017-10-25 |
| 1265966923 | Kelli Holgate | Social Worker | 30 E Center St, Hyde Park, UT 84318-3236 | 2017-04-19 |
| 1558710996 | Shamieka Layne | Social Worker | 44 Badger Rd, Hyde Park, MA 02136-3302 | 2016-06-07 |
| 1831507425 | Briget Antoinette Evans | Social Worker | 6 Cheryl Ln, Hyde Park, MA 02136-1219 | 2014-07-26 |
| 1588002695 | Samantha Louis | Social Worker | 314 Wood Ave, Hyde Park, MA 02136-3755 | 2013-06-11 |
| 1568755437 | Edgar Acosta | Social Worker | 121 Child St, Hyde Park, MA 02136-1716 | 2011-05-25 |
| Find all providers in HYDE PARK | ||||
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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.