Active NPI
Nicole Mary Breen, M.ED., LMHC
- Mental Health Counselor
- Worcester, MA
National Provider Identifier
1851930499
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 11622
- Practice address
- 500 Salisbury St
Worcester, MA 01609-1265 - Phone
- (339) 237-1152
- NPI assigned
- Dec 30, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 11622 | MA | Primary |
Addresses
Primary practice location
500 Salisbury St
Worcester, MA 01609-1265
Mailing address
500 Salisbury St
Worcester, MA 01609-1265
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11622 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1577664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662940800000",
"number": "1851930499",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 SALISBURY ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016091265"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 SALISBURY ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016091265",
"telephone_number": "339-237-1152"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREEN",
"first_name": "NICOLE",
"middle_name": "MARY",
"name_prefix": "Ms.",
"credential": "M.ED., LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-30",
"last_updated": "2022-09-12",
"certification_date": "2022-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "11622",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.