Provider Demographics
NPI:1770541948
Name:COMPREHENSIVE OUTPATIENT SERVICES INC.
Entity type:Organization
Organization Name:COMPREHENSIVE OUTPATIENT SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:LESLIE
Authorized Official - Last Name:MERMELSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:ED D,
Authorized Official - Phone:617-527-4610
Mailing Address - Street 1:2 COURTHOUSE LN
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-1715
Mailing Address - Country:US
Mailing Address - Phone:978-275-9444
Mailing Address - Fax:978-453-9394
Practice Address - Street 1:2 COURTHOUSE LN
Practice Address - Street 2:SUITE 3
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-1715
Practice Address - Country:US
Practice Address - Phone:978-275-9444
Practice Address - Fax:978-453-9394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4196101YA0400X, 101YP2500X, 101YS0200X, 103TC0700X, 103TC1900X, 103TP2701X, 103TS0200X, 1041C0700X, 106H00000X, 163WP0809X, 2084P0800X, 2084P0804X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, AdultGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA215480000OtherMAGELLAN
MA215483000OtherMAGELLAN
MA1000930OtherBEACON
MAM18559OtherBCBS
MA1300491Medicaid
MA701784OtherTUFTS
MAM18561OtherBCBS
MA001262OtherVALUE OPTIONS
MA1307592Medicaid
MA7672103OtherAETNA
MA1307614Medicaid
MA980524OtherNETWORK HEALTH
MA=========OtherTEAMSTERS
MA=========OtherUBH
MA701784OtherTUFTS
MA1307614Medicaid
MAM18559OtherBCBS
MA7672103OtherAETNA