Individual provider Active NPI

Elizabeth Anne Bradley

  • Student in an Organized Health Care Education/Training Program
  • Lawrence, MA
National Provider Identifier
1326577974
Registry record updated Feb 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
12 Methuen St
Lawrence, MA 01840-1700
Phone
(978) 620-1250
NPI assigned
Jun 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

12 Methuen St
Lawrence, MA 01840-1700

Mailing address

12 Methuen St
Lawrence, MA 01840-1700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240122000904 MA Practitioner - Mental Health Counselor 9739531179 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Riverside Community Care IncGroup PAC ID 6709799885, 117 clinicians

Practice addresses (Care Compare)

176 W St
Milford, MA 01757-2236
Phone (508) 529-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Community Care, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

270 Bridge St
Ste 301
Dedham, MA 02026
Phone (617) 230-9905

176 West St
Milford, MA 01757
Phone (508) 529-7000

190 Lenox St
Norwood, MA 02062
Phone (781) 769-8670

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519344000000",
    "number": "1326577974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 METHUEN ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018401700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 METHUEN ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018401700",
            "telephone_number": "978-620-1250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-07",
        "last_updated": "2018-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, MA

Sources for this page

Verify at the official NPI Registry.