Individual provider Active NPI

Bernadette Licata, LMT,NCTMB

  • Massage Therapist
  • Plymouth Meeting, PA
National Provider Identifier
1144478066
Registry record updated Jan 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MSG000151 Issued in PA
Practice address
8 Country Club Cir
Plymouth Meeting, PA 19462-2519
Phone
(610) 209-0344
NPI assigned
Sep 4, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MSG000151 PA Primary

Addresses

Primary practice location

8 Country Club Cir
Plymouth Meeting, PA 19462-2519

Mailing address

8 Country Club Cir
Plymouth Meeting, PA 19462-2519
Phone (610) 209-0344

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MSG000151PAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1220486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327363200000",
    "number": "1144478066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 COUNTRY CLUB CIR",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194622519",
            "telephone_number": "610-209-0344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 COUNTRY CLUB CIR",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194622519",
            "telephone_number": "610-209-0344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICATA",
        "first_name": "BERNADETTE",
        "name_prefix": "Mrs.",
        "credential": "LMT,NCTMB",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-04",
        "last_updated": "2012-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "PA",
            "license": "MSG000151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth Meeting, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.