| Good Samaritan Hospital Behavioral Medicine | |
|
235 N Pearl St Brockton MA 02301-1794 | |
| (508) 427-2841 | |
| Not Available |
| Full Name | Good Samaritan Hospital Behavioral Medicine |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 235 N Pearl St, Brockton, Massachusetts |
| Authorized Official Name and Position | Paula A Wyman (CORP DIRECTOR OF REIMBURSEMENT) |
| Authorized Official Contact | 7813753308 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Good Samaritan Hospital Behavioral Medicine 30 Perwal St Westwood MA 02090-1928 Ph: (781) 375-3308 | Good Samaritan Hospital Behavioral Medicine 235 N Pearl St Brockton MA 02301-1794 Ph: (508) 427-2841 |
| NPI Number | 1922516053 |
|---|---|
| Provider Enumeration Date | 01/10/2018 |
| Last Update Date | 01/10/2018 |
| Medicare PECOS PAC ID | 8123214715 |
|---|---|
| Medicare Enrollment ID | O20180502000736 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922516053 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| 282N00000X | General Acute Care Hospital | 2311 (Massachusetts) | Primary |
| Provider Name | Nicole Dasilva |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336398817 PECOS PAC ID: 3274711999 Enrollment ID: I20110629000192 |
| Provider Name | Kristina M Serena |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184893109 PECOS PAC ID: 8426229006 Enrollment ID: I20110913000279 |
| Provider Name | Melissa B Dawson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184051260 PECOS PAC ID: 8224268230 Enrollment ID: I20140312001603 |
| Provider Name | Brittany M Lynch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770904005 PECOS PAC ID: 2769784891 Enrollment ID: I20160107000045 |
| Provider Name | Megan Berube |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336697911 PECOS PAC ID: 8123307634 Enrollment ID: I20161125000005 |
| Provider Name | Andrea Pasko Garcia |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609068345 PECOS PAC ID: 6305123340 Enrollment ID: I20170501001225 |
| Provider Name | Cindy Rodrigues Medeiros |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811214182 PECOS PAC ID: 8426380817 Enrollment ID: I20191105000783 |
| Provider Name | Megan Kathleen Gaw |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780938423 PECOS PAC ID: 7214362029 Enrollment ID: I20200123002234 |
| Provider Name | Emma Jane Whisner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407390149 PECOS PAC ID: 9234511403 Enrollment ID: I20220804000960 |
| Provider Name | Melanie Corr |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174871495 PECOS PAC ID: 9234511387 Enrollment ID: I20220805000901 |
| Provider Name | Tara Sue Raczka |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497403109 PECOS PAC ID: 6103296603 Enrollment ID: I20221227001804 |
| Provider Name | John Ruggiero |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275073827 PECOS PAC ID: 4183096092 Enrollment ID: I20230202000105 |
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