Active NPI
Madison Detwiler
- Mental Health Counselor
- Brookline, MA
National Provider Identifier
1326670936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 10001975
- Practice address
- 1180 Beacon St Ste 4C
Brookline, MA 02446-3806 - Phone
- (617) 294-9803
- NPI assigned
- Feb 11, 2020
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 10001975 | MA | Primary |
| Behavior Technician | 106S00000X | 19-106453 | AR |
Addresses
Primary practice location
1180 Beacon St Ste 4C
Brookline, MA 02446-3806
Mailing address
1180 Beacon St Ste 4C
Brookline, MA 02446-3806
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 |
|---|---|---|---|
| 19-106453 | AR | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789084800000",
"number": "1326670936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1180 BEACON ST STE 4C",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024463806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1180 BEACON ST STE 4C",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024463806",
"telephone_number": "617-294-9803"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DETWILER",
"first_name": "MADISON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-11",
"last_updated": "2026-09-11",
"certification_date": "2026-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "10001975",
"primary": true
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "AR",
"license": "19-106453",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookline, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.