Provider Demographics
NPI:1447970694
Name:MATTICK BEHAVIORAL HEALTH SERVICES INC
Entity type:Organization
Organization Name:MATTICK BEHAVIORAL HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYEE/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:SELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:617-936-8588
Mailing Address - Street 1:1400 HANCOCK ST FL 9
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-5233
Mailing Address - Country:US
Mailing Address - Phone:617-936-8588
Mailing Address - Fax:617-463-9518
Practice Address - Street 1:1400 HANCOCK ST FL 9
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-5233
Practice Address - Country:US
Practice Address - Phone:617-936-8588
Practice Address - Fax:617-463-9518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-29
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty