Active NPI
Breanne Muchemore, LICSW, CCM
- Clinical Social Worker
- Charlestown, MA
National Provider Identifier
1053899237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 118074
- Practice address
- 300 1St Ave
Charlestown, MA 02129-3109 - Phone
- (617) 952-5341
- NPI assigned
- Jul 31, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 118074 | MA | Primary |
Addresses
Primary practice location
300 1St Ave
Charlestown, MA 02129-3109
Mailing address
300 1St Ave
Charlestown, MA 02129-3109
Phone (617) 952-5341
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
| License | State | Type | Specialty |
|---|---|---|---|
| 118074 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532995200000",
"number": "1053899237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 1ST AVE",
"city": "CHARLESTOWN",
"state": "MA",
"postal_code": "021293109",
"telephone_number": "617-952-5341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 1ST AVE",
"city": "CHARLESTOWN",
"state": "MA",
"postal_code": "021293109",
"telephone_number": "617-952-5341"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUCHEMORE",
"first_name": "BREANNE",
"credential": "LICSW, CCM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-31",
"last_updated": "2018-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "118074",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlestown, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.