Provider Demographics
NPI:1174536809
Name:ASSOCIATES OF MERRIMACK VALLEY INC
Entity type:Organization
Organization Name:ASSOCIATES OF MERRIMACK VALLEY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT COOWNER CODIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SIEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:978-256-1467
Mailing Address - Street 1:201 CHELMSFORD ST
Mailing Address - Street 2:
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824
Mailing Address - Country:US
Mailing Address - Phone:978-256-1467
Mailing Address - Fax:978-256-7465
Practice Address - Street 1:201 CHELMSFORD ST
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824
Practice Address - Country:US
Practice Address - Phone:978-256-1467
Practice Address - Fax:978-256-7465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Not Answered261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1018562OtherCIGNA BEHAVIORAL HEALTH
306079OtherMANAGED HEALTH NETWORK
1010500OtherBEACON HEALTH STRATEGIES
W10410OtherBCBS PSYCH
42682OtherMAGELLON BEHAVIORAL HLTH
614070OtherTUFTS HEALTH PLAN
CP0025OtherBCBS RNCS
MA1102303Medicaid
111038OtherBEHAVIORAL HEALTH NETWORK
M16842OtherBLUE CROSS BLUE SHIELD
CP0025OtherBCBS RNCS