| Patriot Behavioral Health Inc. | |
|
1261 Furnace Brook Parkway Suite 22 Quincy MA 02169 | |
| (617) 302-2481 | |
| (617) 472-6947 |
| Full Name | Patriot Behavioral Health Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 1261 Furnace Brook Parkway, Quincy, Massachusetts |
| Authorized Official Name and Position | Alexandra L Accardi (OWNER, CEO) |
| Authorized Official Contact | 7742191490 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Patriot Behavioral Health Inc. 1261 Furnace Brook Parkway Suite 22 Quincy MA 02169 Ph: (617) 302-2481 | Patriot Behavioral Health Inc. 1261 Furnace Brook Parkway Suite 22 Quincy MA 02169 Ph: (617) 302-2481 |
| NPI Number | 1518085968 |
|---|---|
| Provider Enumeration Date | 03/26/2007 |
| Last Update Date | 08/24/2020 |
| Certification Date | 08/24/2020 |
| Medicare PECOS PAC ID | 6901878297 |
|---|---|
| Medicare Enrollment ID | O20040811001416 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518085968 | NPI | - | NPPES |
| 9712411 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TB0200X | Psychologist - Cognitive & Behavioral | (* (Not Available)) | Primary |
| Provider Name | Sumio Shinohara |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1457401564 PECOS PAC ID: 4082740139 Enrollment ID: I20100424000005 |
| Provider Name | Sasheen Hazel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740684877 PECOS PAC ID: 6800157959 Enrollment ID: I20180306001002 |
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