Individual provider Active NPI

Bren Palla, LICSW

  • Clinical Social Worker
  • Northampton, MA
National Provider Identifier
1841210283
Registry record updated Oct 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
113074 Issued in MA
Practice address
105 Marian St
Northampton, MA 01060-1116
Phone
(413) 626-2896
NPI assigned
Jul 20, 2006
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 113074 MA Primary

Addresses

Primary practice location

105 Marian St
Northampton, MA 01060-1116

Mailing address

105 Marian St
Northampton, MA 01060-1116
Phone (413) 626-2896

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
I20050926000171 MA Practitioner - Clinical Social Worker 8224061015 Practice locations: Northampton, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Northampton, MA 01060
Phone (413) 626-2896

105 Marian St
Northampton, MA 01060-1116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Inc PastSince Feb 2, 2025 Accepting new patients

Organizations & group practices 1

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728172800000",
    "number": "1841210283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 MARIAN ST",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "010601116",
            "telephone_number": "413-626-2896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MARIAN ST",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "010601116",
            "telephone_number": "413-626-2896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALLA",
        "first_name": "BREN",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "U",
        "enumeration_date": "2006-07-20",
        "last_updated": "2024-10-06",
        "certification_date": "2024-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "113074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northampton, MA

Sources for this page

Verify at the official NPI Registry.