| Mercury Behavioral Health Of Massachusetts Pc | |
|
580 Harrison Ave Ste 2b Boston MA 02118-2440 | |
| (224) 622-5470 | |
| Not Available |
| Full Name | Mercury Behavioral Health Of Massachusetts Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 580 Harrison Ave Ste 2b, Boston, Massachusetts |
| Authorized Official Name and Position | Jennie Byrne (PRESIDENT/DIRECTOR) |
| Authorized Official Contact | 9194285154 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercury Behavioral Health Of Massachusetts Pc 548 Market St Ste 17462 San Francisco CA 94104-5401 Ph: (443) 498-3972 | Mercury Behavioral Health Of Massachusetts Pc 580 Harrison Ave Ste 2b Boston MA 02118-2440 Ph: (224) 622-5470 |
| NPI Number | 1912752650 |
|---|---|
| Provider Enumeration Date | 04/17/2024 |
| Last Update Date | 01/15/2025 |
| Certification Date | 01/15/2025 |
| Medicare PECOS PAC ID | 1355882564 |
|---|---|
| Medicare Enrollment ID | O20240916000677 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912752650 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Jennie Byrne |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194947259 PECOS PAC ID: 8426122748 Enrollment ID: I20240916000810 |
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