Organization
NORTH CHARLES MENTAL HEALTH RESEARCH & TRAINING FOUNDATION, INC
Active
Other names
NORTH CHARLES, INC.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY R HOULE (CEO)
(617) 864-0941
Entity
Organization
Contact information
Practice address
54 WASHBURN AVE, CAMBRIDGE, MA 02140-1128
(617) 864-0941
(617) 876-9760
Mailing address
54 WASHBURN AVE, CAMBRIDGE, MA 02140-1128
(617) 864-0941
(617) 876-9760
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
Primary
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
2084P0800X
Psychiatry Physician
—
—
2084P0802X
Addiction Psychiatry Physician
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1005250
—
MA
01
—
119333300
DEPT LABOR OWCP
MA
05
—
1303902
—
MA
05
—
1303929
—
MA
05
—
1306405
—
MA
01
—
222301740
BLUE CROSS BLUE SHIELD
MA
01
—
37052
BOSTON HEALTHNET
MA
05
—
99420501
—
MA
01
—
NHC222300091 40
BLUE CROSS BLUE SHIELD
MA
01
—
NHC222300091 41
BLUE CROSS BLUE SHIELD
MA
01
—
NHC222300091 42
BLUE CROSS BLUE SHIELD
MA
Enumeration date
11/09/2006
Last updated
01/24/2020
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