Individual provider Active NPI

Brooke Diane Melanson

  • Mental Health Counselor
  • Newton, MA
National Provider Identifier
1053881912
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
12455 Issued in MA
Practice address
233 Needham St
Newton, MA 02464-1573
Phone
(774) 203-4671
NPI assigned
Dec 4, 2018
Last updated
Dec 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 12455 MA Primary

Addresses

Primary practice location

233 Needham St
Newton, MA 02464-1573

Mailing address

233 Needham St
Newton, MA 02464-1573
Phone (774) 203-4671

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241213001708 MA Practitioner - Mental Health Counselor 5597291567 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12455MAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince Nov 13, 2024 Accepting new patients
Strength in Solutions, LLC Mental Health Current Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

100 Cambridge St
Fl 14
Boston, MA 02114
Phone (617) 917-2389

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1543881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1053881912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 NEEDHAM ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024641573",
            "telephone_number": "774-203-4671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 NEEDHAM ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024641573",
            "telephone_number": "774-203-4671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELANSON",
        "first_name": "BROOKE",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-04",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "12455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, MA

Sources for this page

Verify at the official NPI Registry.