Individual provider Active NPI

Kimberlee Ann Dennery, LICSW

  • Clinical Social Worker
  • Boston, MA
National Provider Identifier
1023165115
Registry record updated Mar 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
113274 Issued in MA
Practice address
581 Boylston Street
Suite 301B
Boston, MA 02116
Phone
(617) 960-7857
NPI assigned
Jan 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 113274 MA Primary

Addresses

Primary practice location

581 Boylston Street
Suite 301B
Boston, MA 02116

Mailing address

581 Boylston Street
Suite 301B
Boston, MA 02116
Phone (617) 960-7857

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)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363824000000",
    "number": "1023165115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "581 BOYLSTON STREET",
            "address_2": "SUITE 301B",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02116",
            "telephone_number": "617-960-7857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "581 BOYLSTON STREET",
            "address_2": "SUITE 301B",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02116",
            "telephone_number": "617-960-7857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNERY",
        "first_name": "KIMBERLEE",
        "middle_name": "ANN",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2013-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "113274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 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.

Verify at the official NPI Registry.