Active NPI
Patricia Brouwer, LCDP; LMHC
- Mental Health Counselor
- Johnston, RI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MHC00714
- 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, 2016
- 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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GH57134 | Medicaid | RI |
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
Enrollment records 1
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| CDP00338 | RI | MD | Addiction (Substance Use Disorder) Counselor |
| MHC00714 | RI | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gateway Healthcare Inc | Current | 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Pawtucket, RI
- NPI 1821078932
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.