Organization Active NPI

Re-United Behavioral Health Services

  • Mental Health Counselor
  • Brockton, MA
National Provider Identifier
1548715964
Registry record updated Aug 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
119810 Issued in MA
Legal business name
RE-UNITED BEHAVIORAL HEALTH SERVICES
Practice address
425 Pleasant St
Brockton, MA 02301-2533
Phone
(617) 678-7492
NPI assigned
Aug 16, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2016

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

Authorized official

Name
Ludger Labissiere, LICSW
Title
Owner
Phone
(617) 678-7492

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 119810 MA Primary

Addresses

Primary practice location

425 Pleasant St
Brockton, MA 02301-2533

Mailing address

425 Pleasant St
Brockton, MA 02301-2533
Phone (617) 678-7492

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1471305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471305600000",
    "number": "1548715964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 PLEASANT ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023012533",
            "telephone_number": "617-678-7492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 PLEASANT ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023012533",
            "telephone_number": "617-678-7492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RE-UNITED BEHAVIORAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-16",
        "last_updated": "2016-08-16",
        "status": "A",
        "authorized_official_last_name": "LABISSIERE",
        "authorized_official_first_name": "LUDGER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-678-7492",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "119810",
            "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 Aug 16, 2016; 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.