Michael Brodmerkle

Individual provider Active NPI Behavior Analyst · Lunenburg, MA

NPI 1992336341 · NPPES record last updated Jan 31, 2024

Key facts

NPI
1992336341
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
4230 (MA)
Practice address
39 Main St
Lunenburg, MA 01462-1428
Phone
(978) 790-5793
NPI assigned
Feb 3, 2020
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Shapiro Educational & Behavioral Consultants, LLC Past
since Feb 4, 2024
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 4230 MA Yes

Addresses

Primary practice location

39 Main St
Lunenburg, MA 01462-1428

Mailing address

12 Marshall St Apt 3
Worcester, MA 01604-2869
Phone (978) 204-3215

Other providers in Lunenburg, MA

All providers in Lunenburg, MA · Behavior Analyst in Massachusetts

Sources for this page

Verify at the official NPI Registry.