Active NPI
Erin Theriault
- Addiction (Substance Use Disorder) Counselor
- Brighton, MA
National Provider Identifier
1457782120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- S94640572
- Practice address
- 9 Winship St
Brighton, MA 02135-3359 - Phone
- (413) 896-8972
- NPI assigned
- Dec 6, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | S94640572 | MA | Primary |
| Mental Health Counselor | 101YM0800X | S94640572 | MA |
Addresses
Primary practice location
9 Winship St
Brighton, MA 02135-3359
Mailing address
9 Winship St
Brighton, MA 02135-3359
Phone (413) 896-8972
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 |
|---|---|---|---|
| S94640572 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1386288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386288000000",
"number": "1457782120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 WINSHIP ST",
"city": "BRIGHTON",
"state": "MA",
"postal_code": "021353359",
"telephone_number": "413-896-8972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 WINSHIP ST",
"city": "BRIGHTON",
"state": "MA",
"postal_code": "021353359",
"telephone_number": "413-896-8972"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THERIAULT",
"first_name": "ERIN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-12-06",
"last_updated": "2013-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MA",
"license": "S94640572",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "S94640572",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brighton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.