Active NPI
Rebecca Wassell, LICSW
- Clinical Social Worker
- Waltham, MA
National Provider Identifier
1063762144
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 120125
- Practice address
- 419 Moody St # 1012
Waltham, MA 02453-0401 - Phone
- (781) 746-8354
- Fax
- (781) 205-1631
- NPI assigned
- Sep 14, 2012
- Last updated
- Jun 23, 2026
- Sex
- Female
- Sole proprietor
- Yes
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 | 120125 | MA | Primary |
Addresses
Primary practice location
419 Moody St # 1012
Waltham, MA 02453-0401
Mailing address
419 Moody St # 1012
Waltham, MA 02453-0401
Phone (781) 746-8354
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 1, 2024 through Mar 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 120125 | MA | MD | Pediatric Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782172800000",
"number": "1063762144",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "419 MOODY ST # 1012",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024530401",
"telephone_number": "781-746-8354",
"fax_number": "781-205-1631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "419 MOODY ST # 1012",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024530401",
"telephone_number": "781-746-8354",
"fax_number": "781-205-1631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WASSELL",
"first_name": "REBECCA",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-09-14",
"last_updated": "2026-06-23",
"certification_date": "2026-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "120125",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waltham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.