Individual provider Active NPI

Nissa Hauer

  • Mental Health Counselor
  • Leominster, MA
National Provider Identifier
1609288760
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
10000975 Issued in MA
Practice address
80 Erdman Way Ste 208
Leominster, MA 01453-1840
Phone
(978) 870-1840
NPI assigned
May 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 10000975 MA Primary

Addresses

Primary practice location

80 Erdman Way Ste 208
Leominster, MA 01453-1840

Mailing address

80 Erdman Way Ste 208
Leominster, MA 01453-1840
Phone (978) 870-1840

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
I20241016001688 MA Practitioner - Mental Health Counselor 3971035817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
SB Transitional Sub LLCGroup PAC ID 7911315379, 70 clinicians

Practice addresses (Care Compare)

80 Erdman Way
Suite 208
Leominster, MA 01453-1840
Phone (508) 521-2200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10000975MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
SB Transitional Sub, LLC CurrentSince Jul 12, 2024 Accepting new patients
South Bay Mental Health Center, Inc. CurrentSince Jul 12, 2024 Accepting new patients

Locations

103 Commercial St
Ste 2
Brockton, MA 02302

1115 W Chestnut St
Brockton, MA 02301
Phone (508) 559-0473

80 Erdman Way
Ste 208
Leominster, MA 01453
Phone 9788701840 ext. 1019

Organizations & group practices 2

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": "1400803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1609288760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 ERDMAN WAY STE 208",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014531840",
            "telephone_number": "978-870-1840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 ERDMAN WAY STE 208",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014531840",
            "telephone_number": "978-870-1840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUER",
        "first_name": "NISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-23",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "10000975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leominster, MA

Sources for this page

Verify at the official NPI Registry.