NPIMap

Individual provider Active NPI

Colleen Byrnes, M.S.W.

  • Clinical Social Worker
  • West Roxbury, MA
National Provider Identifier
1114115490
Registry record updated Oct 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1017475 Issued in MA
Practice address
83 Temple St
West Roxbury, MA 02132-3855
Phone
(617) 325-8050
NPI assigned
Oct 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1017475 MA Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1018 MA

Addresses

Primary practice location

83 Temple St
West Roxbury, MA 02132-3855

Mailing address

83 Temple St
West Roxbury, MA 02132-3855
Phone (617) 325-8050

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
1018MAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193443200000",
    "number": "1114115490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 TEMPLE ST",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021323855",
            "telephone_number": "617-325-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 TEMPLE ST",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021323855",
            "telephone_number": "617-325-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYRNES",
        "first_name": "COLLEEN",
        "name_prefix": "Ms.",
        "credential": "M.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-11",
        "last_updated": "2007-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1017475",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "1018",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Roxbury, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2007; 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.