Radiance LLC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

RADIANCE LLC

Practice address

33 Dover St Ste 313
Brockton, MA 02301-5973

Phone

(774) 494-2135

Fax

(339) 444-2717

NPI assigned

Feb 22, 2024

Organization subpart

No

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

Authorized official

Name

Debroah Ford, LADC INPI 1689313298

Title

Owner

Phone

(774) 494-2135

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Debroah Ford

  • Addiction (Substance Use Disorder) Counselor
  • Brockton, MA
  • NPI 1689313298
  NPD Authorized official

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

{
    "created_epoch": "1708560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708560000000",
    "number": "1851157309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 DOVER ST STE 313",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015973",
            "telephone_number": "774-494-2135",
            "fax_number": "339-444-2717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 DOVER ST STE 313",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015973",
            "telephone_number": "774-494-2135",
            "fax_number": "339-444-2717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-22",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "DEBROAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "774-494-2135",
        "authorized_official_credential": "LADC I"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Brockton, MA
• Providers in Brockton, MA by specialty
• Addiction (Substance Use Disorder) Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; 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.