Active NPI
Carrie Dyball, LICSW
- School Social Worker
- Weston, MA
National Provider Identifier
1073097192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Social Worker
- Practice address
- 10 Alphabet LN
Weston, MA 02493-2555 - Phone
- (781) 786-5300
- NPI assigned
- Sep 25, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Social Worker | 1041S0200X | Primary | ||
| Clinical Social Worker | 1041C0700X | 111574 | MA |
Addresses
Primary practice location
10 Alphabet LN
Weston, MA 02493-2555
Mailing address
10 Alphabet LN
Weston, MA 02493-2555
Phone (781) 786-5308
Other practice location 1
11 River St Ste 2
Wellesley, MA 02481-2036
Phone (781) 591-2977
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NONE | Other | NONE |
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 |
|---|---|---|---|
| 111574 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665014400000",
"number": "1073097192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 ALPHABET LN",
"city": "WESTON",
"state": "MA",
"postal_code": "024932555",
"telephone_number": "781-786-5308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 ALPHABET LN",
"city": "WESTON",
"state": "MA",
"postal_code": "024932555",
"telephone_number": "781-786-5300"
}
],
"practiceLocations": [
{
"address_1": "11 River St Ste 2",
"address_purpose": "LOCATION",
"city": "Wellesley",
"state": "MA",
"postal_code": "024812036",
"country_code": "US",
"telephone_number": "781-591-2977",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DYBALL",
"first_name": "CARRIE",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-25",
"last_updated": "2022-10-06",
"certification_date": "2022-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": null,
"license": null,
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "111574",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NONE",
"identifier": "NONE",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Weston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.