| Martha's Vineyard Community Services, Inc. | |
|
111 Edgartown Rd Oak Bluffs MA 02557 | |
| (508) 693-7900 | |
| Not Available |
| Full Name | Martha's Vineyard Community Services, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 111 Edgartown Rd, Oak Bluffs, Massachusetts |
| Authorized Official Name and Position | Glenn J Stalgren (BUSINESS ADMINISTRATOR) |
| Authorized Official Contact | 5086937900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Martha's Vineyard Community Services, Inc. 111 Edgartown Rd Vineyard Haven MA 02568-5699 Ph: (508) 693-7900 | Martha's Vineyard Community Services, Inc. 111 Edgartown Rd Oak Bluffs MA 02557 Ph: (508) 693-7900 |
| NPI Number | 1659387074 |
|---|---|
| Provider Enumeration Date | 07/31/2006 |
| Last Update Date | 10/28/2019 |
| Medicare PECOS PAC ID | 4385552496 |
|---|---|
| Medicare Enrollment ID | O20041214000373 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659387074 | NPI | - | NPPES |
| 1310143 | Medicaid | MA | |
| M18486 | Other | MA | BCBSMA PROVIDER # |
| 1301543 | Medicaid | MA |
| Provider Name | Charles H Silberstein |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548311228 PECOS PAC ID: 2961468731 Enrollment ID: I20041203000076 |
| Provider Name | Cynthia Susan Carter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871695072 PECOS PAC ID: 8123070463 Enrollment ID: I20050215000962 |
| Provider Name | Donna S Stevens Goldf |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1104956432 PECOS PAC ID: 1355379165 Enrollment ID: I20050802001253 |
| Provider Name | John S Turton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841324365 PECOS PAC ID: 4385745306 Enrollment ID: I20070720000509 |
| Provider Name | Dominic J Maxwell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134178106 PECOS PAC ID: 9931180833 Enrollment ID: I20090930000254 |
| Provider Name | Maria K Grotz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972634806 PECOS PAC ID: 6204995699 Enrollment ID: I20120801000181 |
| Provider Name | Janet Ann Constantino |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1912006867 PECOS PAC ID: 2567682123 Enrollment ID: I20141002000101 |
| Provider Name | Gail Gordon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700077690 PECOS PAC ID: 6709189848 Enrollment ID: I20160122000797 |
| Provider Name | Ralle Rae Greenberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154818409 PECOS PAC ID: 4789925348 Enrollment ID: I20190408002398 |
| Provider Name | Jennifer L Hawken |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972984581 PECOS PAC ID: 5890091227 Enrollment ID: I20190411001534 |
| Provider Name | Paul G Cotton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477560811 PECOS PAC ID: 9436167921 Enrollment ID: I20210405001375 |
| Provider Name | Eric T Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487011433 PECOS PAC ID: 5193134971 Enrollment ID: I20210506002700 |
| Provider Name | Mary Elizabeth Karlan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871976431 PECOS PAC ID: 8224311071 Enrollment ID: I20210603002168 |
| Provider Name | Jacob Mozes-reisman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972987535 PECOS PAC ID: 5890192132 Enrollment ID: I20210929000640 |
| Provider Name | Alberta K Adu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528722451 PECOS PAC ID: 8628432192 Enrollment ID: I20230918000100 |
| Provider Name | Kathleen Mary Burnspower |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467566653 PECOS PAC ID: 0840635611 Enrollment ID: I20240302000242 |
| Provider Name | Luiza Alencar Mouzinho |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144657511 PECOS PAC ID: 9739526401 Enrollment ID: I20240318003171 |
| Provider Name | Virginia Sherwood |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366678609 PECOS PAC ID: 2860839412 Enrollment ID: I20240319002325 |
| Provider Name | Thomas S Bennett |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376743187 PECOS PAC ID: 2961840517 Enrollment ID: I20240402003186 |
| Provider Name | Katherine Federowicz Perez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780109702 PECOS PAC ID: 7618315813 Enrollment ID: I20240408001577 |
| Provider Name | Mary Louise Purves |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225541881 PECOS PAC ID: 8123466240 Enrollment ID: I20240409000435 |
| Provider Name | Susan M Warren |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780282335 PECOS PAC ID: 2769822329 Enrollment ID: I20240430000622 |