Active NPI
Nina Leigh Soares, LICSW
- Clinical Social Worker
- Brockton, MA
National Provider Identifier
1033412465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 118657
- Practice address
- 940 Belmont St
Brockton, MA 02301-5568 - Phone
- (817) 825-3816
- NPI assigned
- Dec 7, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 118657 | MA | Primary |
Addresses
Primary practice location
940 Belmont St
Brockton, MA 02301-5568
Mailing address
2743 Cranberry Hwy Apt 5D
Wareham, MA 02571-1069
Phone (774) 454-4320
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 |
|---|---|---|---|
| 118657 | MA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nina L Soares | Clinical | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1291680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685059200000",
"number": "1033412465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2743 CRANBERRY HWY APT 5D",
"city": "WAREHAM",
"state": "MA",
"postal_code": "025711069",
"telephone_number": "774-454-4320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "940 BELMONT ST",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023015568",
"telephone_number": "817-825-3816"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOARES",
"first_name": "NINA",
"middle_name": "LEIGH",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-12-07",
"last_updated": "2023-05-26",
"certification_date": "2023-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "118657",
"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 May 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.