Individual provider Active NPI

Julie Klink, LICSW

  • Clinical Social Worker
  • Nashua, NH
National Provider Identifier
1063000107
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2336 Issued in NH
Practice address
19 Tyler St Ste 103
Nashua, NH 03060-2951
Phone
(603) 281-9709
NPI assigned
Jan 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

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 2336 NH Primary

Addresses

Primary practice location

19 Tyler St Ste 103
Nashua, NH 03060-2951

Mailing address

PO Box 3677
Nashua, NH 03061-3677
Phone (603) 577-7900

Other names 1

  • Julie Coyne Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20210212002169 NH Practitioner - Clinical Social Worker 0244645802

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

PO Box
Suite 3677
Nashua, NH 03061-3677

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2336NHMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Foundation Medical Partners Inc CurrentSince Mar 28, 2021 Accepting new patients
Foundation Medical Partners Inc. CurrentSince Mar 28, 2021 Accepting new patients

Locations

10 Jones Rd
Milford, NH 03055
Phone (603) 672-7600

19 Tyler St
Ste 103
Nashua, NH 03060
Phone (603) 577-3100

Organizations & group practices 2

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": "1609804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1063000107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3677",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030613677",
            "telephone_number": "603-577-7900",
            "fax_number": "603-577-7972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 TYLER ST STE 103",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030602951",
            "telephone_number": "603-281-9709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINK",
        "first_name": "JULIE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-05",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "2336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "COYNE",
            "credential": "LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Nashua, NH

Sources for this page

Verify at the official NPI Registry.