Individual provider Active NPI

Sonia Dettmann, LICSW

  • Clinical Social Worker
  • Andover, MA
National Provider Identifier
1043398084
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1025812 Issued in MA
Practice address
3 Dundee Park Dr
General Psych Assoc Ste 203
Andover, MA 01810-3723
Phone
(978) 475-3590
Fax
(978) 475-7620
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

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 1025812 MA Primary

Addresses

Primary practice location

3 Dundee Park Dr
General Psych Assoc Ste 203
Andover, MA 01810-3723

Mailing address

106 Berkshire St
Cambridge, MA 02141-1417
Phone (617) 492-6497

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
General Psychological Associates PastSince Jun 1, 2012 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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043398084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 BERKSHIRE ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021411417",
            "telephone_number": "617-492-6497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 DUNDEE PARK DR",
            "address_2": "GENERAL PSYCH ASSOC STE 203",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018103723",
            "telephone_number": "978-475-3590",
            "fax_number": "978-475-7620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETTMANN",
        "first_name": "SONIA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1025812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.