Dominique Stassart, MSW,LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

110629 Issued in MA

Practice address

22 Leonard Ave
#2
Cambridge, MA 02139-1020

Phone

(617) 784-8163

NPI assigned

Jan 1, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1167609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1023174141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 LEONARD AVE",
            "address_2": "#2",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021391020",
            "telephone_number": "617-784-8163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 LEONARD AVE",
            "address_2": "#2",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021391020",
            "telephone_number": "617-784-8163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STASSART",
        "first_name": "DOMINIQUE",
        "name_prefix": "Ms.",
        "credential": "MSW,LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-01",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "110629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1857673",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "P07813",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK HEALTH",
            "identifier": "1036030",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "500567",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandra Starck, R.PH.
• Jenna Nicole Stark, LICSW
• Aileen Starnbach, MD
• Lisa S. Starobin, MD
• Stars to Success, LLC
• Amalia Vicky Stavropoulos
• Evangeline Despina Stefanakis, ED.D.
• Louis Miller Stein
• Brenda Miriam Steinberg, PHD
• Gerald Steinberg, MD

• Clinical Social Worker in Cambridge, MA
• Providers in Cambridge, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.