Individual provider Active NPI

Martha Wernimont, MSW, LICSW

  • Clinical Social Worker
  • Brookline, MA
National Provider Identifier
1043687411
Registry record updated Sep 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1024624 Issued in MA
Practice address
1415 Beacon St
Suite 200
Brookline, MA 02446-4816
Phone
(857) 654-0832
NPI assigned
Sep 1, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2015

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 1024624 MA Primary

Addresses

Primary practice location

1415 Beacon St
Suite 200
Brookline, MA 02446-4816

Mailing address

83 Saint Rose St
Jamaica Plain, MA 02130-3927
Phone (857) 654-0832

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
I20160104001432 MA Practitioner - Clinical Social Worker 2961704267 Practice locations: Brookline, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1415 Beacon St
Suite 200
Brookline, MA 02446-4819
Phone (857) 654-0832

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1441065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441065600000",
    "number": "1043687411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 SAINT ROSE ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021303927",
            "telephone_number": "857-654-0832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 BEACON ST",
            "address_2": "SUITE 200",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024464816",
            "telephone_number": "857-654-0832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERNIMONT",
        "first_name": "MARTHA",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-01",
        "last_updated": "2015-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1024624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

Verify at the official NPI Registry.