Michael Blanchard, LADC-II

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Brewster, MA

NPI 1104178219 · NPPES record last updated Oct 12, 2012

Key facts

NPI
1104178219
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
2277 (MA)
Practice address
745 Harwich Rd
Brewster, MA 02631-2536
Phone
(774) 994-0412
NPI assigned
Oct 12, 2012
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2277MAMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 2277 MA Yes

Addresses

Primary practice location

745 Harwich Rd
Brewster, MA 02631-2536

Mailing address

PO Box 852
Brewster, MA 02631-0852

Other providers in Brewster, MA

All providers in Brewster, MA · Addiction (Substance Use Disorder) Counselor in Massachusetts

Sources for this page

Verify at the official NPI Registry.