Individual provider Active NPI

Laura Anne Rheault, APRN

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Lawrence, MA
National Provider Identifier
1649032848
Registry record updated Apr 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X
License
2023153303 Issued in MA
Practice address
12 Methuen St
Lawrence, MA 01840-1772
Phone
(978) 683-3128
NPI assigned
Jan 24, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X 2023153303 MA Primary

Addresses

Primary practice location

12 Methuen St
Lawrence, MA 01840-1772

Mailing address

12 Methuen St
Lawrence, MA 01840-1772

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240423004420 MA Practitioner - Nurse Practitioner 8729427786 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2023153303MAMDPsychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Crystal Lake Wellness, PLLC Current Accepting new patients
Northeast Behavioral Health Corporation CurrentSince Mar 25, 2024 Accepting new patients

Locations

199 Rosewood Dr
Ste 250
Danvers, MA 01923
Phone (978) 867-7756

12 Methuen St
Ste 3
Lawrence, MA 01840
Phone (978) 683-3128

12 Methuen St
Lawrence, MA 01840
Phone (978) 620-1770

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": "1706054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712448000000",
    "number": "1649032848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 METHUEN ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018401772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 METHUEN ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018401772",
            "telephone_number": "978-683-3128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RHEAULT",
        "first_name": "LAURA",
        "middle_name": "ANNE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-24",
        "last_updated": "2024-04-07",
        "certification_date": "2024-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "MA",
            "license": "2023153303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, MA

Sources for this page

Verify at the official NPI Registry.