Healthcare Provider Details

I. General information

NPI: 1972431401
Provider Name (Legal Business Name): MEGAN KATHERINE BREMER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 HANCOCK ST STE 306
QUINCY MA
02169-5244
US

IV. Provider business mailing address

61 STRATHMORE RD APT 3
BOSTON MA
02135-7937
US

V. Phone/Fax

Practice location:
  • Phone: 617-404-3621
  • Fax:
Mailing address:
  • Phone: 315-982-1711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: