MR. GARY J BREAULT – Professional Counselor, NPI 1104071315

MR. GARY J BREAULT is a healthcare provider. based in Worcester, Massachusetts. specializing in MENTAL HEALTH COUNSELOR. They hold a License No. 6675 (MA). The NPI Number for MR. GARY J BREAULT is 1104071315

Main info

Male
Sole Proprietor
35 Years Of Experience
Accepts Medicare Assignment
Name
MR. GARY J BREAULT
NPI
1104071315
Phone
(508) 754-3006
Address
25 CATHARINE ST
Enumeration Date
2 December 2008
Last Update Date
2 December 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5089814367
Graduation Year
1991 (35 years ago)
PAC ID
3971008475
Group Practice PAC ID
8820145394
Professional Enrollment ID
I20250925002247
Address ID
MA016091989WO255XXAVEX302
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness75
Years active:17State licenses:2Digital endpointsOther names

2,116 MENTAL HEALTH COUNSELOR in MA

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Provider Addresses for MR. GARY J BREAULT

  • 25, Catharine Street, Lincoln Square, Chandler Hill, Worcester, Worcester County, Massachusetts, 01605, United States

    WORCESTER, MA 016052709

    Phone: (508) 754-3006

    Fax: (508) 754-2971

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-09-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250925002247IMental Health CounselorMATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 01605)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8820145394View full group profile
NameSpecialtyState
Mental Health CounselorMA
Certified Clinical Nurse Specialist (Cns)MA
Clinical PsychologistMA
Clinical Social WorkerMA

Reviews

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Frequently asked questions

What identifier follows MR. GARY J BREAULT across health systems?
The NPI 1104071315 uniquely identifies MR. GARY J BREAULT in U.S. healthcare data.
Does the public listing show MR. GARY J BREAULT as active?
MR. GARY J BREAULT's NPI record reflects an active status in NPPES.
How should patients interpret MR. GARY J BREAULT's specialty?
The extract shows Professional Counselor for MR. GARY J BREAULT. Clinical services aligned with this taxonomy classification.
Is MR. GARY J BREAULT tied to Worcester, Massachusetts?
If you are local to Worcester, Massachusetts, MR. GARY J BREAULT may be relevant to your search.
Who maintains MR. GARY J BREAULT's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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