Healthcare Provider Details

I. General information

NPI: 1306902861
Provider Name (Legal Business Name): TRI-CITY MENTAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

173 CHELSEA ST
EVERETT MA
02149-4632
US

IV. Provider business mailing address

5 OCEAN TER
SALEM MA
01970-5421
US

V. Phone/Fax

Practice location:
  • Phone: 978-388-6258
  • Fax:
Mailing address:
  • Phone: 978-388-6258
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number213
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number113874
License Number StateMA

VIII. Authorized Official

Name: MR. ROSS KLEIMAN
Title or Position: VP CLINICAL SERVICES
Credential: PH.D.
Phone: 781-388-6257