Organization Active NPI

Nautilus Counseling & Wellness LLC

  • Adult Mental Health Clinic/Center
  • Pembroke, MA
National Provider Identifier
1841963287
Registry record updated Jul 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
NAUTILUS COUNSELING & WELLNESS LLC
Practice address
28 Riverside Dr Ste 200
Pembroke, MA 02359-4947
Phone
(781) 561-1384
NPI assigned
Jul 30, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2021

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

Authorized official

Name
Jill Marie Brazao, LMHCNPI 1235388018
Title
Owner
Phone
(781) 248-3730

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

28 Riverside Dr Ste 200
Pembroke, MA 02359-4947

Mailing address

33 Bonney St
Pembroke, MA 02359-2414
Phone (781) 248-3730

National Provider Directory

National Provider Directory

Locations

28 Riverside Dr
Ste 200
Pembroke, MA 02359
Phone (781) 561-1384

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1627603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627603200000",
    "number": "1841963287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 BONNEY ST",
            "city": "PEMBROKE",
            "state": "MA",
            "postal_code": "023592414",
            "telephone_number": "781-248-3730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 RIVERSIDE DR STE 200",
            "city": "PEMBROKE",
            "state": "MA",
            "postal_code": "023594947",
            "telephone_number": "781-561-1384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAUTILUS COUNSELING & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-30",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A",
        "authorized_official_last_name": "BRAZAO",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-248-3730",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.

Verify at the official NPI Registry.