Individual provider Active NPI

Beverly Ruth Hubler, L.I.C.S.W.

  • Clinical Social Worker
  • Brockton, MA
National Provider Identifier
1033690607
Registry record updated Aug 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1020819 Issued in MA
Practice address
567 Pleasant St Ste 101
Brockton, MA 02301-2507
Phone
(508) 584-3339
Fax
(508) 584-3556
NPI assigned
Aug 22, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 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 1020819 MA Primary

Addresses

Primary practice location

567 Pleasant St Ste 101
Brockton, MA 02301-2507

Mailing address

567 Pleasant St Ste 101
Brockton, MA 02301-2507
Phone (508) 584-3339

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
1020819MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1534896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534896000000",
    "number": "1033690607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "567 PLEASANT ST STE 101",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023012507",
            "telephone_number": "508-584-3339",
            "fax_number": "508-584-3556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "567 PLEASANT ST STE 101",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023012507",
            "telephone_number": "508-584-3339",
            "fax_number": "508-584-3556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBLER",
        "first_name": "BEVERLY",
        "middle_name": "RUTH",
        "name_prefix": "Ms.",
        "credential": "L.I.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-22",
        "last_updated": "2018-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1020819",
            "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 Aug 22, 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.