Active NPI
Audrey Breault, M.A.
- Behavior Analyst
- Woburn, MA
National Provider Identifier
1760774533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 10 Gill St Ste J
Woburn, MA 01801-1721 - Phone
- (617) 505-6184
- NPI assigned
- May 11, 2011
- Last updated
- Jul 15, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
10 Gill St Ste J
Woburn, MA 01801-1721
Mailing address
10 Gill St Ste J
Woburn, MA 01801-1721
Phone (617) 505-6184
Other practice location 1
148 Warren St
Lowell, MA 01852-2208
Phone (978) 452-1736
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Behavioral Concepts | Current | Accepting new patients | |
| South Bay Mental Health Center | Past | Accepting new patients |
Locations
10 Gill St
#J
Woburn, MA 01801
Phone (617) 505-6183
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Behavior Technician
- Woburn, MA
- NPI 1063008530
-
- Community/Behavioral Health Agency
- Lowell, MA
- NPI 1790092088
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626307200000",
"number": "1760774533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 GILL ST STE J",
"city": "WOBURN",
"state": "MA",
"postal_code": "018011721",
"telephone_number": "617-505-6184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 GILL ST STE J",
"city": "WOBURN",
"state": "MA",
"postal_code": "018011721",
"telephone_number": "617-505-6184"
}
],
"practiceLocations": [
{
"address_1": "148 Warren St",
"address_purpose": "LOCATION",
"city": "Lowell",
"state": "MA",
"postal_code": "018522208",
"country_code": "US",
"telephone_number": "978-452-1736",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BREAULT",
"first_name": "AUDREY",
"credential": "M.A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-05-11",
"last_updated": "2021-07-15",
"certification_date": "2021-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woburn, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.