Individual provider Active NPI

Jill Scott Devitt, LICSW

  • Clinical Social Worker
  • Waltham, MA
National Provider Identifier
1033392923
Registry record updated Dec 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1026953 Issued in MA
Practice address
395 Totten Pond Rd
Waltham, MA 02451-2007
Phone
(857) 373-9337
NPI assigned
Dec 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2018

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 1026953 MA Primary

Addresses

Primary practice location

395 Totten Pond Rd
Waltham, MA 02451-2007

Mailing address

395 Totten Pond Rd
Waltham, MA 02451-2007
Phone (857) 373-9337

Other practice location 1

3 Thornton St
Newton, MA 02458-1519
Phone (857) 373-9337

Other identifiers 1

IdentifierTypeStateIssuer
P08739OtherMABLUE CROSS BLUE SHIELD

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

LicenseStateTypeSpecialty
1026953MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544400000000",
    "number": "1033392923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 TOTTEN POND RD",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024512007",
            "telephone_number": "857-373-9337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 TOTTEN POND RD",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024512007",
            "telephone_number": "857-373-9337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Thornton St",
            "address_purpose": "LOCATION",
            "city": "Newton",
            "state": "MA",
            "postal_code": "024581519",
            "country_code": "US",
            "telephone_number": "857-373-9337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEVITT",
        "first_name": "JILL",
        "middle_name": "SCOTT",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-13",
        "last_updated": "2018-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1026953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "P08739",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2018; 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.