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Contact Information

WESTSIDE BEHAVIORAL HEALTH, LLC
7 CHRISTY DRIVE
SUITE 3
BROCKTON, MA02301
 Phone: 508-580-4611
 Fax: 508-580-4404
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Psychiatric/Mental Health

163WP0808X
 

Psychiatric/Mental Health, Adult

364SP0809X 89 Certified Clinical Nurse Specialist
 

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for WESTSIDE BEHAVIORAL HEALTH, LLC

NPI # 1689720302
LBN Legal business name WESTSIDE BEHAVIORAL HEALTH, LLC
Authorized official MICHAEL WEINER - (PARTENER)
Entity Organization
Organization subpart 1 No
Enumeration date 01/26/2007
Last updated 04/20/2008 - About 18 years ago
Identifiers
MA License # 1027200
MA License # 104590
MA License # 105028
MA License # 110746
MA License # 135140
MA License # 35081
MA License # 7330
MA License # 8177
MA License # 90943
MA License # 94523
MA Other P10235 BLUE CROSS GROUP NUMBER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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