Individual provider Active NPI

Anne Rutter, L.I.C.S.W.

  • Clinical Social Worker
  • Brookline, MA
National Provider Identifier
1043373269
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1019738 Issued in MA
Practice address
124 Harvard St
Brookline, MA 02446-6478
Phone
(617) 232-4350
NPI assigned
Dec 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1019738 MA Primary

Addresses

Primary practice location

124 Harvard St
Brookline, MA 02446-6478

Mailing address

40 Alveston St
Jamaica Plain, MA 02130-2817
Phone (617) 522-5236

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20041014000621 MA Practitioner - Clinical Social Worker 4385604222 Practice locations: Brookline, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

124 Harvard St
Brookline, MA 02446-6478
Phone (617) 232-4350

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1019738MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043373269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 ALVESTON ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021302817",
            "telephone_number": "617-522-5236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 HARVARD ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024466478",
            "telephone_number": "617-232-4350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTTER",
        "first_name": "ANNE",
        "credential": "L.I.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1019738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

Verify at the official NPI Registry.