Individual provider Active NPI

Patricia Brouwer, LCDP; LMHC

  • Mental Health Counselor
  • Johnston, RI
National Provider Identifier
1841573698
Registry record updated Aug 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MHC00714 Issued in RI
Practice address
1516 Atwood Ave
Johnston, RI 02919-3223
Phone
(401) 553-1000
Fax
(401) 553-1143
NPI assigned
Sep 27, 2011
Last updated
Aug 10, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MHC00714 RI Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X CDP00338 RI

Addresses

Primary practice location

1516 Atwood Ave
Johnston, RI 02919-3223

Mailing address

1516 Atwood Ave
Johnston, RI 02919-3223
Phone (401) 553-1000

Other identifiers 1

IdentifierTypeStateIssuer
GH57134MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20240208003411 RI Practitioner - Mental Health Counselor 6901249721 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gateway Healthcare IncGroup PAC ID 7719874908, 66 clinicians

Practice addresses (Care Compare)

1443 Hartford Ave
Johnston, RI 02919-3224
Phone (401) 273-8100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CDP00338RIMDAddiction (Substance Use Disorder) Counselor
MHC00714RIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Gateway Healthcare Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

1516 Atwood Ave
Johnston, RI 02919
Phone (401) 463-8829

1443 Hartford Ave
Providence, RI 02919
Phone (401) 273-8100

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

1 Virginia Ave
Ste 200
Providence, RI 02905

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1317081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470787200000",
    "number": "1841573698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1516 ATWOOD AVE",
            "city": "JOHNSTON",
            "state": "RI",
            "postal_code": "029193223",
            "telephone_number": "401-553-1000",
            "fax_number": "401-553-1143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1516 ATWOOD AVE",
            "city": "JOHNSTON",
            "state": "RI",
            "postal_code": "029193223",
            "telephone_number": "401-553-1000",
            "fax_number": "401-553-1143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUWER",
        "first_name": "PATRICIA",
        "credential": "LCDP; LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-27",
        "last_updated": "2016-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "RI",
            "license": "MHC00714",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "RI",
            "license": "CDP00338",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GH57134",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnston, RI

Sources for this page

Verify at the official NPI Registry.