Individual provider Active NPI

Brianna Wadler, PHD

  • Counseling Psychologist
  • Quincy, MA
National Provider Identifier
1467024562
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
PSY5000486 Issued in MA
Practice address
2300 Crown Colony Dr Ste 202
Quincy, MA 02169-0902
Phone
(781) 312-8416
NPI assigned
Jul 16, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X PSY5000486 MA Primary

Addresses

Primary practice location

2300 Crown Colony Dr Ste 202
Quincy, MA 02169-0902

Mailing address

2300 Crown Colony Dr Ste 202
Quincy, MA 02169-0902
Phone (781) 312-8416

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
I20240726002640 MA Practitioner - Clinical Psychologist 4486190329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Child and Family Psychological Services PLLCGroup PAC ID 5991763823, 260 clinicians

Practice addresses (Care Compare)

2300 Crown Colony Dr
Suite 202
Quincy, MA 02169-0902
Phone (781) 551-0999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Family Psychological Services, PLLC Psychologist CurrentSince Jun 19, 2024 Accepting new patients

Locations

89 Access Rd
Ste 24
Norwood, MA 02062
Phone (781) 336-5040

2300 Crown Colony Dr
Ste 202
Quincy, MA 02169
Phone (617) 405-5735

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": "1626393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1467024562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 CROWN COLONY DR STE 202",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021690902",
            "telephone_number": "781-312-8416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 CROWN COLONY DR STE 202",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021690902",
            "telephone_number": "781-312-8416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADLER",
        "first_name": "BRIANNA",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-16",
        "last_updated": "2024-06-10",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MA",
            "license": "PSY5000486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.