Bruce Edward Deveau, LICSW

Individual provider Active NPI Clinical Social Worker · Newburyport, MA

NPI 1043301187 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1043301187
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
111489 (MA)
Practice address
42 Pleasant St
Suite 7
Newburyport, MA 01950-2606
Phone
(978) 462-3287
Fax
(978) 462-3287
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
Yes

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.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

102 Bridge Rd
Suite 2 L
Salisbury, MA 01952-2410
Phone (978) 462-3287

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20050106000279 MA Practitioner - Clinical Social Worker 1052369030 Practice locations: Salisbury, MA

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
111489MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Patricia Dell-Ross, Inc. Clinical Past
since Jul 6, 2000
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 111489 MA Yes

Addresses

Primary practice location

42 Pleasant St
Suite 7
Newburyport, MA 01950-2606

Mailing address

42 Pleasant St
Suite 7
Newburyport, MA 01950-2606
Phone (978) 462-3287

Other providers in Newburyport, MA

All providers in Newburyport, MA · Clinical Social Worker in Massachusetts

Sources for this page

Verify at the official NPI Registry.