Broad Meadow Cooperative LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

BROAD MEADOW COOPERATIVE LLC

Practice address

7 Cuba St
Andover, MA 01810-3407

Phone

(978) 494-4460

NPI assigned

Apr 14, 2023

Organization subpart

No

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

Authorized official

Name

Bradley Thomas Eardley, LMFTNPI 1134386139

Title

Owner

Phone

(978) 494-4460

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bradley T Eardley, MA, LMFT

  • Marriage & Family Therapist
  • Andover, MA
  • NPI 1134386139
  Medicare reassignment NPD Authorized official
• Ying Zhang

  • Mental Health Counselor
  • Andover, MA
  • NPI 1174497044
  NPD
• Barbara Conrad, LCSW

  • Clinical Social Worker
  • Lawrence, MA
  • NPI 1033634126
  NPD (past)

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

{
    "created_epoch": "1681430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681430400000",
    "number": "1760178453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 CUBA ST",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018103407",
            "telephone_number": "978-494-4460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 CUBA ST",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018103407",
            "telephone_number": "978-494-4460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROAD MEADOW COOPERATIVE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-14",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A",
        "authorized_official_last_name": "EARDLEY",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "978-494-4460",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Paola Bravo Sosa, CNP
• Constance K Breen, NP
• Tracy Breen, LICSW
• Kim Briggs, M.ED. CCC-SLP
• Krystal Brighton
• Anthony C Broccoli, DMD
• Brittany Broderick, PSY.D.
• Amanda Stacey Bronson, PSY.D.
• Hillary Brooks
• Browell and Murphy

• Mental Health Counselor in Andover, MA
• Providers in Andover, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.