NPIMap

Organization Active NPI

Brian Crockett Counseling, LLC

  • Addiction (Substance Use Disorder) Counselor
  • Milford, MA
National Provider Identifier
1306402649
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
BRIAN CROCKETT COUNSELING, LLC
Practice address
89 Main St Ste 304
Milford, MA 01757-2600
Phone
(978) 536-1056
NPI assigned
May 13, 2019
Last updated
Jun 11, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Authorized official

Name
Brian Crockett, MATH, LADC1, CFTP
Title
Owner, Counselor
Phone
(978) 979-7257

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU Primary

Addresses

Primary practice location

89 Main St Ste 304
Milford, MA 01757-2600

Mailing address

89 Main St Ste 304
Milford, MA 01757-2600
Phone (978) 536-1056

Other identifiers 1

IdentifierTypeStateIssuer
1376848309MedicaidMA

National Provider Directory

National Provider Directory

Locations

89 Main St
Ste 304
Milford, MA 01757
Phone (978) 536-1056

NPI Registry JSON

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

{
    "created_epoch": "1557705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1306402649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 MAIN ST STE 304",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "017572600",
            "telephone_number": "978-536-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 MAIN ST STE 304",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "017572600",
            "telephone_number": "978-536-1056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN CROCKETT COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-13",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "CROCKETT",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER, COUNSELOR",
        "authorized_official_telephone_number": "978-979-7257",
        "authorized_official_credential": "MATH, LADC1, CFTP"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376848309",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.