| Uplift Behavioral Health | |
|
5260 Washington St Ste 12 West Roxbury MA 02132-6354 | |
| (617) 942-6040 | |
| Not Available |
| Full Name | Uplift Behavioral Health |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 5260 Washington St Ste 12, West Roxbury, Massachusetts |
| Authorized Official Name and Position | Daniel Jeannite (PRESIDENT) |
| Authorized Official Contact | 6179426040 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Uplift Behavioral Health 5260 Washington St Ste 12 West Roxbury MA 02132-6354 Ph: (617) 942-6040 | Uplift Behavioral Health 5260 Washington St Ste 12 West Roxbury MA 02132-6354 Ph: (617) 942-6040 |
| NPI Number | 1245982990 |
|---|---|
| Provider Enumeration Date | 01/24/2022 |
| Last Update Date | 01/10/2024 |
| Certification Date | 08/14/2023 |
| Medicare PECOS PAC ID | 0042677510 |
|---|---|
| Medicare Enrollment ID | O20230530000689 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245982990 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Edith S Pepper |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033428495 PECOS PAC ID: 5890976559 Enrollment ID: I20110301000320 |
| Provider Name | Helen Nikitin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194847954 PECOS PAC ID: 7315194016 Enrollment ID: I20120831000521 |
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