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RIVERSIDE COMMUNITY CARE
NPI 1174907000
Community/Behavioral Health in Somerville, MA

Active since July 09, 2015CLIA 22D2292111 · Waiver
12 TYLER ST, SOMERVILLE, MA 02143(781) 364-0940 Get Directions Write a Review

NPPES record last updated: July 9, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Riverside Community Care NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RIVERSIDE COMMUNITY CARE (NPI 1174907000) is a healthcare organization registered as a community/behavioral health in Somerville, Massachusetts and active in the NPI registry since July 2015. The organization holds a CLIA Waiver certificate valid through October 19, 2027 and lists Jacqueline Marie Fickes, Intensive Care Coordinator, as its authorized official.

NPPES Registry Identity

NPI1174907000
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NameRIVERSIDE COMMUNITY CARE
Location Address12 TYLER STSomerville, MA 02143-3241
Mailing Address12 Tyler StSomerville, MA 02143-3241
Phone(781) 364-0940
Organization SubpartNo
Authorized OfficialJacqueline Marie FickesIntensive Care Coordinator · (781) 364-0940
Enumeration DateJuly 9, 2015
✔ NPI 1174907000 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
12 TYLER ST, Somerville, MA 02143
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 22D2292111

Riverside Community Care, Inc · Somerville, MA
Active · expires Oct 19, 2027
CLIA Number22D2292111
Laboratory TypeOutpatient Behavioral Hth
Certificate Effective DateOctober 20, 2025
Certificate Expiration DateOctober 19, 2027
Laboratory DirectorAsia Taylor
Laboratory Phone(781) 600-4751
Laboratory LocationRiverside Community Care, Inc117 Summer Street, 2nd Floor, Somerville, MA 02143
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JULIA JOHNS MS CCC-SLP
Speech-Language Pathologist
12 TYLER ST
SOMERVILLE, MA 02143
Middlesex County (617) 629-3919
LAURA ANN MIGNERY CPS
Peer Specialist
12 TYLER ST
SOMERVILLE, MA 02143
Middlesex County (508) 904-6466
MS. ROBERTA BISCAN
Counselor
12 TYLER ST
SOMERVILLE, MA 02143
Middlesex County (617) 629-3919
JOHANNY NUNEZ
Social Worker (Clinical)
12 TYLER ST
SOMERVILLE, MA 02143
Middlesex County (781) 752-9517
THE GUIDANCE CENTER
Community/Behavioral Health
12 TYLER ST
SOMERVILLE, MA 02143
Middlesex County (617) 702-5771
COLLEEN LAVORATO
Community Health Worker
12 TYLER ST
SOMERVILLE, MA 02143
Middlesex County (781) 686-8567
MIRTA AURORA SANTANDER
Developmental Therapist
12 TYLER ST
SOMERVILLE, MA 02143
Middlesex County (617) 702-5797
MARY ALICE LARAMIE MA
Counselor (Mental Health)
12 TYLER ST
SOMERVILLE, MA 02143
Middlesex County (781) 752-9499

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Riverside Community Care's NPI number?

The NPI number for Riverside Community Care is 1174907000. It was assigned to this organization in the NPPES registry on July 9, 2015.

Where is Riverside Community Care located?

Riverside Community Care is located at 12 Tyler St, Somerville, MA 02143. The listed phone number is (781) 364-0940.

What is Riverside Community Care's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

Does Riverside Community Care hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 22D2292111) is associated with this NPI, valid through October 19, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Riverside Community Care was last updated on July 9, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.