Provider Demographics
NPI:1053185272
Name:INTEGRATED BEHAVIORAL CARE NEW ENGLAND LLC
Entity type:Organization
Organization Name:INTEGRATED BEHAVIORAL CARE NEW ENGLAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MEETING
Authorized Official - Middle Name:
Authorized Official - Last Name:MOUZAKIS
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW, LEP
Authorized Official - Phone:978-886-2359
Mailing Address - Street 1:431 JOHNSON ST
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-4721
Mailing Address - Country:US
Mailing Address - Phone:978-886-2359
Mailing Address - Fax:
Practice Address - Street 1:800 TURNPIKE ST STE 300
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-6156
Practice Address - Country:US
Practice Address - Phone:978-296-5595
Practice Address - Fax:978-296-5594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-08
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty