Old Colony Young Men's Christian Association, Inc.
NPI 1366506677ActiveOrganization· Psychologist, Clinical· Brockton, MA
Psychologist, Clinical in Brockton, Massachusetts, registered in NPPES in December 2006. The authorized official on file is Donna J. Desmond, CPA, MBA, Evp, Cfo. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1366506677 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 21, 2006 |
| Last updated in NPPES | Mar 1, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | 4796 | MA |
| Social Worker, Clinical | 1041C0700X | 4796 | MA |
| Health Educator | 174H00000X | — | — |
| Psychiatry & Neurology, Child & Adolescent Psychiatry | 2084P0804X | 4796 | MA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MA) |
|---|
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