MEDICARE: DR. NICHOLAS M. BRISBON PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LMHC11231	MA
2	101YM0800X	Mental Health Counselor	MHC01947	RI
3	101YA0400X	Addiction (Substance Use Disorder) Counselor	LMHC11231	MA
4	101YA0400X	Addiction (Substance Use Disorder) Counselor	MHC01947	RI

General Provider Information

NPI Number	:	1316475064
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICHOLAS M. BRISBON PHD

Provider Business Mailing Address
First Line	:	1241 GRAND ARMY HWY
Second Line	:
City	:	SWANSEA
State	:	MA
Zip	:	02777-4212
Country	:	US
Telephone Number	:	508-642-3884
Fax Number	:

Provider Business Practice Location Address
First Line	:	1241 GRAND ARMY HWY
Second Line	:
City	:	SWANSEA
State	:	MA
Zip	:	02777-4212
Country	:	US
Telephone Number	:	508-642-3884
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2017
Last Update Date	:	02/10/2026

Similar Medicare Providers

1730044223 — ATHELAS COUNSELING AND CONSULTING, PLLC
Practice Location Address:

1241 GRAND ARMY HWY
SWANSEA, MA
02777-4212

Practice Phone: 508-642-3884
Practice Fax:

1073607651 — DR. JOSEPH PATRICK COSTELLO III MD
Practice Location Address:

4212 N ILLINOIS ST
SWANSEA, IL
62226-1835

Practice Phone: 618-233-6685
Practice Fax: 618-233-6616

1003052028 — COSKIDS PEDIATRICS LTD
Practice Location Address:

4212 N ILLINOIS ST
SWANSEA, IL
62226-1835

Practice Phone: 618-233-6685
Practice Fax:

1841165925 — SHERANGELIA RAICHEL MCCLAIN
Practice Location Address:

1400 N 2ND ST
SWANSEA, IL
62226-4212

Practice Phone: 314-319-9916
Practice Fax: 314-319-9916

1982557559 — IVANNYA VERONICA DA SILVA
Practice Location Address:

262 SWANSEA MALL DR STE 701
SWANSEA, MA
02777-4151

Practice Phone: 888-880-9244
Practice Fax:

1417800483 — THERAPY IN BLOOM PLLC
Practice Location Address:

25 MARKET ST
SWANSEA, MA
02777-3999

Practice Phone: 401-323-7993
Practice Fax:

Directions to “ DR. NICHOLAS M. BRISBON PHD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.