FRIENDS OF THE SHATTUCK SHELTER NPI 1497897250

NPI Information

NPI: 1497897250
Provider Name: FRIENDS OF THE SHATTUCK SHELTER
Classification: Counselor - 101YA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

Address:
170 MORTON ST
JAMAICA PLAIN, MA
ZIP 02130
Phone: (617) 983-0351
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FRIENDS OF THE SHATTUCK SHELTER is an addiction (substance use disorder) counselor in Jamaica Plain, MA. FRIENDS OF THE SHATTUCK SHELTER NPI is 1497897250. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

170 MORTON ST
JAMAICA PLAIN, MA
ZIP 02130-735
Phone: (617) 983-0351
Fax: (617) 971-9339

The provider's authorized official is Deborah Putnam .
The authorized official title is Director Of Program Development and has the following contact phone number (617) 983-0351.

The enumeration date for this NPI number is 2/12/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	0796	MASSACHUSETTS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1302311	MEDICAID	MASSACHUSETTS
2	1302311	OTHER	MASSACHUSETTS	VALUE OPTIONS (MBHP)
3	000000020458	OTHER	MASSACHUSETTS	BMC HEALTHNET
4	1028790	OTHER	MASSACHUSETTS	BEACON HEALTH STRATEGIES

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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