Healthcare Provider Details

I. General information

NPI: 1285564211
Provider Name (Legal Business Name): MADISON BREUER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 ERDMAN WAY
LEOMINSTER MA
01453-1804
US

IV. Provider business mailing address

26 FLAGG RD
HUBBARDSTON MA
01452-1308
US

V. Phone/Fax

Practice location:
  • Phone: 978-969-3762
  • Fax:
Mailing address:
  • Phone: 978-407-4578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: