Individual provider Active NPI

Sobhan Namvar, LICSW

  • Clinical Social Worker
  • Needham, MA
National Provider Identifier
1104214410
Registry record updated Jan 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LICSW 118706 Issued in MA
Practice address
19 Murphy Rd
Needham, MA 02492-2110
Phone
(617) 642-7274
NPI assigned
Jan 8, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2015

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 LICSW 118706 MA Primary

Addresses

Primary practice location

19 Murphy Rd
Needham, MA 02492-2110

Mailing address

19 Murphy Rd
Needham, MA 02492-2110
Phone (617) 642-7274

Other identifiers 1

IdentifierTypeStateIssuer
LICSW 118706OtherMABOARD OF SOCIAL WORK

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

LicenseStateTypeSpecialty
LICSW 118706MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Be Well at Black Barn Farm LLC Current Accepting new patients

Organizations & group practices 1

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": "1420675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420675200000",
    "number": "1104214410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 MURPHY RD",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024922110",
            "telephone_number": "617-642-7274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 MURPHY RD",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024922110",
            "telephone_number": "617-642-7274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAMVAR",
        "first_name": "SOBHAN",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-01-08",
        "last_updated": "2015-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "LICSW 118706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF SOCIAL WORK",
            "identifier": "LICSW 118706",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Needham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2015; 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.