Active NPI
Brenda M Drake, LICSW
- Clinical Social Worker
- Concord, NH
National Provider Identifier
1073868824
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1614
- Practice address
- 50 Pleasant St
Concord, NH 03301-4073 - Phone
- (603) 703-7364
- NPI assigned
- Jul 18, 2012
- Last updated
- Jul 18, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 1614 | NH | Primary |
Addresses
Primary practice location
50 Pleasant St
Concord, NH 03301-4073
Mailing address
716 N Pembroke Rd
Pembroke, NH 03275-3805
Phone (603) 703-7364
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 28, 2024 through Oct 28, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1614 | NH | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342569600000",
"number": "1073868824",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "716 N PEMBROKE RD",
"city": "PEMBROKE",
"state": "NH",
"postal_code": "032753805",
"telephone_number": "603-703-7364"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 PLEASANT ST",
"city": "CONCORD",
"state": "NH",
"postal_code": "033014073",
"telephone_number": "603-703-7364"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRAKE",
"first_name": "BRENDA",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-07-18",
"last_updated": "2012-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NH",
"license": "1614",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.