Active NPI
Jenna M Monaco
- Clinical Social Worker
- Brockton, MA
National Provider Identifier
1013238807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 218820
- Practice address
- 1115 W Chestnut St
Brockton, MA 02301-7501 - Phone
- (508) 580-4691
- NPI assigned
- Jun 16, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 218820 | MA | |
| Clinical Social Worker | 1041C0700X | 218820 | MA | Primary |
Addresses
Primary practice location
1115 W Chestnut St
Brockton, MA 02301-7501
Mailing address
1115 W Chestnut St
Brockton, MA 02301-7501
Phone (508) 580-4691
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 218820 | MA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379980800000",
"number": "1013238807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1115 W CHESTNUT ST",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023017501",
"telephone_number": "508-580-4691"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1115 W CHESTNUT ST",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023017501",
"telephone_number": "508-580-4691"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONACO",
"first_name": "JENNA",
"middle_name": "M",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-06-16",
"last_updated": "2013-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MA",
"license": "218820",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "218820",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brockton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.