Individual provider Active NPI

George Theodore Labarre, LICSW

  • Social Worker
  • Southbridge, MA
National Provider Identifier
1073597704
Registry record updated May 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
103513 Issued in MA
Practice address
29 Pine St
Southbridge, MA 01550
Phone
(508) 765-9167
Fax
(508) 764-2462
NPI assigned
Dec 6, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 103513 MA Primary

Addresses

Primary practice location

29 Pine St
Southbridge, MA 01550

Mailing address

29 Pine St
Southbridge, MA 01550
Phone (508) 765-9167

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
103513MAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306800000000",
    "number": "1073597704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 PINE ST",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "01550",
            "telephone_number": "508-765-9167",
            "fax_number": "508-764-2462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 PINE ST",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "01550",
            "telephone_number": "508-765-9167",
            "fax_number": "508-764-2462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABARRE",
        "first_name": "GEORGE",
        "middle_name": "THEODORE",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2011-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "103513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southbridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.