Organization Active NPI

Lilac Behavioral Health PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Fitchburg, MA
National Provider Identifier
1629989785
Registry record updated Sep 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
LILAC BEHAVIORAL HEALTH PLLC
Practice address
105 Sanborn St
Fitchburg, MA 01420-3756
Phone
(508) 479-2969
Fax
(978) 506-1759
NPI assigned
Sep 16, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2026

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

Authorized official

Name
Krista Madrid, PMHNP-BC
Title
Pmhnp
Phone
(508) 479-2969

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

105 Sanborn St
Fitchburg, MA 01420-3756

Mailing address

105 Sanborn St
Fitchburg, MA 01420-3756
Phone (508) 479-2969

NPI Registry JSON

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

{
    "created_epoch": "1789516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789516800000",
    "number": "1629989785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 SANBORN ST",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014203756",
            "telephone_number": "508-479-2969",
            "fax_number": "978-506-1759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 SANBORN ST",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014203756",
            "telephone_number": "508-479-2969",
            "fax_number": "978-506-1759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LILAC BEHAVIORAL HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-16",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-16",
        "status": "A",
        "authorized_official_last_name": "MADRID",
        "authorized_official_first_name": "KRISTA",
        "authorized_official_title_or_position": "PMHNP",
        "authorized_official_telephone_number": "508-479-2969",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "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 Sep 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.