ALLY INTEGRATED HEALTHCARE NPI 1174022693

NPI Information

NPI: 1174022693
Provider Name: ALLY INTEGRATED HEALTHCARE

Doing Business As: ALLY INTEGRATED HEALTHCARE, PC

Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

Address:
305 NEWBURY ST STE 41
BOSTON, MA
ZIP 02115
Phone: (617) 377-7868
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ALLY INTEGRATED HEALTHCARE is a psychiatric/mental health nurse practitioner in Boston, MA. ALLY INTEGRATED HEALTHCARE NPI is 1174022693. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Ally Integrated Healthcare, Pc.

The provider's business location address is:

305 NEWBURY ST STE 41
BOSTON, MA
ZIP 02115-833
Phone: (617) 377-7868
Fax: (617) 608-5899

The provider's authorized official is Susan S. Wilkinson .
The authorized official title is President/pmhnp-bc and has the following contact phone number (617) 600-4235.

The enumeration date for this NPI number is 2/10/2018 and was last updated on 3/4/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	No
2	101YM0800X	Counselor	Mental Health	No
3	104100000X	Social Worker		No
4	1041C0700X	Social Worker	Clinical	No
5	2083A0300X	Preventive Medicine	Addiction Medicine	No
6	363L00000X	Nurse Practitioner		No
7	363LC1500X	Nurse Practitioner	Community Health	No
8	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	Yes
9	364SP0807X	Clinical Nurse Specialist	Psychiatric/Mental Health, Child & Adolescent	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1174022693	OTHER	MASSACHUSETTS	NPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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