NPIMap

Organization Active NPI

Cleghorn Professional Counseling Center

  • Exclusive Provider Organization
  • Fitchburg, MA
National Provider Identifier
1497052930
Registry record updated Feb 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
0007433 Issued in MA
Legal business name
CLEGHORN PROFESSIONAL COUNSELING CENTER
Practice address
63 Fairmount St Rear
Fitchburg, MA 01420-7613
Phone
(978) 342-2709
Fax
(978) 342-2709
NPI assigned
Feb 18, 2011
Last updated
Feb 18, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2011

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

Authorized official

Name
Dennis Anthony Bradley Sr., LMHCNPI 1841313046
Title
Clinical Director
Phone
(978) 342-2709

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X 0007433 MA Primary

Addresses

Primary practice location

63 Fairmount St Rear
Fitchburg, MA 01420-7613

Mailing address

63 Fairmount St Rear
Fitchburg, MA 01420-7613
Phone (978) 342-2709

National Provider Directory

National Provider Directory
Tax ID family
Cleghorn Professional Counseling Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

63 Fairmount St
Rear
Fitchburg, MA 01420
Phone (978) 342-2709

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1297987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297987200000",
    "number": "1497052930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 FAIRMOUNT ST REAR",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014207613",
            "telephone_number": "978-342-2709",
            "fax_number": "978-342-2709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 FAIRMOUNT ST REAR",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014207613",
            "telephone_number": "978-342-2709",
            "fax_number": "978-342-2709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEGHORN PROFESSIONAL COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-18",
        "last_updated": "2011-02-18",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "978-342-2709",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "MA",
            "license": "0007433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fitchburg, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.