Thomas A Berak
Individual provider Active NPI Behavior Technician · Bedford, MA
NPI 1316477292 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1316477292
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 205 Burlington Rd
Bedford, MA 01730-1406 - Phone
- (781) 761-5089
- NPI assigned
- Jun 14, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Edinburg Center Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
205 Burlington Rd
Bedford, MA 01730-1406
Mailing address
205 Burlington Rd
Bedford, MA 01730-1406
Phone (781) 761-5089
Other practice location 1
41 Pacella Park Dr
Randolph, MA 02368-1755
Phone (781) 440-0400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1004745 | Other | MA | FALLON |
| M18633 | Other | MA | BCBS |
| 0000023532 | Other | MA | BMC |
| 110026265E | Medicaid | MA | |
| 042611055 | Other | MA | TAX ID |
| 1303287 | Other | MA | MBHP |
| 99618201 | Other | MA | NETWORK HEALTH |
| 1004745 | Other | MA | NHP |
Other providers in Bedford, MA
- Philip Bellino II
- Scott Norman Belliveau
- Kelly Jean Bemis
- William Albert Bennett
- Corona Claire Benson
- Joshua Berger
- Heidi A Berke
- Dan Robert Berlowitz
- Alison Marie Bettencourt
- Veronica M. Bevans
All providers in Bedford, MA · Behavior Technician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.