Active NPI
Jean Eve Brickman, LSW, LADC I
- Social Worker
- Worcester, MA
National Provider Identifier
1215447685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 313953
- Practice address
- 4 Mann St
Worcester, MA 01602-3414 - Phone
- (774) 922-3977
- NPI assigned
- Oct 11, 2017
- Last updated
- May 5, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 18380 | MA | |
| Social Worker | 104100000X | 313953 | MA | Primary |
Addresses
Primary practice location
4 Mann St
Worcester, MA 01602-3414
Mailing address
6 North St.
Douglas, MA 01516
Phone (508) 476-7374
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
| License | State | Type | Specialty |
|---|---|---|---|
| 313953 | MA | MD | Social Worker |
| 18380 | MA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620172800000",
"number": "1215447685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 NORTH ST.",
"city": "DOUGLAS",
"state": "MA",
"postal_code": "01516",
"telephone_number": "508-476-7374",
"fax_number": "508-476-9738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 MANN ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016023414",
"telephone_number": "774-922-3977"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRICKMAN",
"first_name": "JEAN",
"middle_name": "EVE",
"credential": "LSW, LADC I",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-11",
"last_updated": "2021-05-05",
"certification_date": "2021-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MA",
"license": "18380",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MA",
"license": "313953",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.