Stephen Brevik
Individual provider Active NPI Clinical Psychologist · Northborough, MA
NPI 1982016937 · NPPES record last updated Jan 29, 2019
Key facts
- NPI
- 1982016937
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 10834 (MA)
- Practice address
- 44 Bearfoot Rd Ste 300
Northborough, MA 01532 - Phone
- (508) 922-0184
- NPI assigned
- May 27, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
48 N Pleasant St
Suite 201
Amherst, MA 01002-1758
Phone (413) 252-8832
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180716000446 | MA | Practitioner - Clinical Psychologist | 4486901998 |
Reassigns benefits to 1 organization Practice locations: Amherst, MA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10834 | MA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| K.C. Psychotherapy | Current | Accepting new patients | |
| Western Massachusetts Psychological Services, LLC | Current |
Accepting new patients |
Locations
48 N Pleasant St
Ste 201
Amherst, MA 01002
Phone (413) 252-8832
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 10834 | MA | Yes |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
44 Bearfoot Rd Ste 300
Northborough, MA 01532
Mailing address
44 Bearfoot Rd Ste 300
Northborough, MA 01532-1559
Phone (781) 474-5227
Other providers in Northborough, MA
- Emily Lynn Bowman
- Anne Boyden
- Bracken Hill Therapeutic Farm LLC
- Lindsay Brady
- Jessica Lou Bready
- Katie Britt
- Jennifer Brown
- Carrie Ann Buda
- Alexandre Earl Burroughs
- Stephanie Lee Butler
All providers in Northborough, MA · Clinical Psychologist in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 29, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.