Individual provider Active NPI

Izabella Lidrbauch, MA, LMHC

  • Mental Health Counselor
  • Newton, MA
National Provider Identifier
1891368510
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LMHC10003206 Issued in MA
Practice address
109 Oak St Ste 201
Newton, MA 02464-1493
Phone
(617) 977-5372
NPI assigned
Jul 20, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X
Music Therapist 225A00000X
Mental Health Counselor 101YM0800X LMHC10003206 MA Primary

Addresses

Primary practice location

109 Oak St Ste 201
Newton, MA 02464-1493

Mailing address

109 Oak St Ste 201
Newton, MA 02464-1493
Phone (617) 977-5372

Other practice location 1

30 Warren St
Brighton, MA 02135-3680
Phone (617) 254-3800 ext. 1314

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20250314002439 MA Practitioner - Mental Health Counselor 0042732489 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ever Human Therapy, PLLCGroup PAC ID 8527506880, 5 clinicians

Practice addresses (Care Compare)

6 Liberty SQ
Suite 257
Boston, MA 02109-5800
Phone (423) 827-5300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LMHC10003206MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Boston Mental Health, PLLC Mental Health CurrentSince Nov 17, 2024 Accepting new patients
Ever Human Therapy, PLLC Mental Health CurrentSince Jan 9, 2025 Accepting new patients

Locations

6 Liberty Sq
Boston, MA 02109
Phone (423) 827-5300

109 Oak St
Ste 201
Newton Upper Falls, MA 02464
Phone (617) 302-9171

3317 Dayton Blvd
Unit 15781
Chattanooga, TN 37415
Phone (423) 827-5300

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1891368510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 OAK ST STE 201",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024641493",
            "telephone_number": "617-977-5372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 OAK ST STE 201",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024641493",
            "telephone_number": "617-977-5372"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Warren St",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MA",
            "postal_code": "021353680",
            "country_code": "US",
            "telephone_number": "617-254-3800 x1314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIDRBAUCH",
        "first_name": "IZABELLA",
        "credential": "MA, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-20",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225A00000X",
            "taxonomy_group": "",
            "desc": "Music Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "LMHC10003206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, MA

Sources for this page

Verify at the official NPI Registry.