Individual provider Active NPI

Bradford Parmenter, LICSW

  • Clinical Social Worker
  • Ayer, MA
National Provider Identifier
1407043284
Registry record updated Nov 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
118405 Issued in MA
Practice address
200 Groton Rd
Ayer, MA 01432-1168
Phone
(197) 878-4900
NPI assigned
Sep 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 118405 MA Primary

Addresses

Primary practice location

200 Groton Rd
Ayer, MA 01432-1168

Mailing address

200 Groton Rd
Ayer, MA 01432-1168
Phone (197) 878-4900

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
I20150219000861 MA Practitioner - Clinical Social Worker 9638494495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Rollins Counseling Center LLCGroup PAC ID 8426460908, 13 clinicians

Practice addresses (Care Compare)

415 Boston Tpke
Suite 314
Shrewsbury, MA 01545-3476
Phone (978) 999-2165

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
118405MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rollins Counseling Center LLC Clinical CurrentSince Jan 29, 2022 Accepting new patients

Locations

415 Boston Tpke
Ste 314
Shrewsbury, MA 01545
Phone (978) 999-2165

70 Broadway St
Westford, MA 01886
Phone (978) 337-3676

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": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416873600000",
    "number": "1407043284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 GROTON RD",
            "city": "AYER",
            "state": "MA",
            "postal_code": "014321168",
            "telephone_number": "197-878-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GROTON RD",
            "city": "AYER",
            "state": "MA",
            "postal_code": "014321168",
            "telephone_number": "197-878-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARMENTER",
        "first_name": "BRADFORD",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-26",
        "last_updated": "2014-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "118405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ayer, MA

Sources for this page

Verify at the official NPI Registry.