Active NPI
Barry Meltzer
- Mental Health Counselor
- Brockton, MA
National Provider Identifier
1356877039
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 12151
- Practice address
- 10 Christy Dr
Brockton, MA 02301-1812 - Phone
- (781) 447-6425
- Fax
- (781) 447-1786
- NPI assigned
- May 2, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 12151 | MA | Primary |
Addresses
Primary practice location
10 Christy Dr
Brockton, MA 02301-1812
Mailing address
10 Christy Dr
Brockton, MA 02301-1812
Phone (781) 447-6425
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 18, 2025 through Feb 18, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12151 | MA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635120000000",
"number": "1356877039",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 CHRISTY DR",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023011812",
"telephone_number": "781-447-6425",
"fax_number": "781-447-1786"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 CHRISTY DR",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023011812",
"telephone_number": "781-447-6425",
"fax_number": "781-447-1786"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELTZER",
"first_name": "BARRY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-05-02",
"last_updated": "2021-10-25",
"certification_date": "2021-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "12151",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brockton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.