Erin Sheridan, LADC, LPC, LMHC
Individual provider Active NPI Mental Health Counselor · Brimfield, MA
NPI 1568719086 · NPPES record last updated Oct 4, 2021
Key facts
- NPI
- 1568719086
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 12596MHCC (MA)
- Practice address
- 1 Main St # 120
Brimfield, MA 01010-9800 - Phone
- (860) 362-0770
- Fax
- (860) 362-0771
- NPI assigned
- Aug 15, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1 Main St
Suite 120
Brimfield, MA 01010-9800
Phone (860) 362-0770
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240518000115 | MA | Practitioner - Mental Health Counselor | 9032550280 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12596MHCC | MA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beautifully Unbroken Counseling LLC | Professional | Current |
Accepting new patients |
Locations
1 Main St
#120
Brimfield, MA 01010
Phone (860) 362-0770
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 001092 | CT | |
| Professional Counselor | 101YP2500X | 003436 | CT | |
| Mental Health Counselor | 101YM0800X | 12596MHCC | MA | Yes |
Addresses
Primary practice location
1 Main St # 120
Brimfield, MA 01010-9800
Mailing address
1 Main St # 120
Brimfield, MA 01010-9800
Phone (860) 362-0770
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004040564 | Medicaid | CT |
Other names
- Erin Sheridan
Other providers in Brimfield, MA
- Katarzyna Pomianowski
- Restore Psychological Services, PLLC
- Haley Richard
- Yasir Saleem
- Christine Flynn Saulnier
- Elizabeth M. Smola
- Kimberly L Vetal
All providers in Brimfield, MA · Mental Health Counselor in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 4, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.