Provider Demographics
NPI:1841973112
Name:BREAKTHROUGH BEHAVIORAL HEALTH, PLLC
Entity type:Organization
Organization Name:BREAKTHROUGH BEHAVIORAL HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADFORD
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:508-213-1326
Mailing Address - Street 1:10 MERCHANTS WAY
Mailing Address - Street 2:STE 6 PMB 303
Mailing Address - City:MIDDLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02346-1843
Mailing Address - Country:US
Mailing Address - Phone:508-213-1326
Mailing Address - Fax:949-695-3569
Practice Address - Street 1:45 SCHOOL ST
Practice Address - Street 2:STE 2 UNIT 5
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-3222
Practice Address - Country:US
Practice Address - Phone:508-213-1326
Practice Address - Fax:949-695-3569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-11
Last Update Date:2025-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty