Individual provider Active NPI

Susan Widdicombe, LICSW

  • Clinical Social Worker
  • Boston, MA
National Provider Identifier
1114605375
Registry record updated May 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LICSW1142050 Issued in MA
Practice address
1 Boston Medical Ctr PL
Boston, MA 02118-2908
Phone
(617) 414-4145
NPI assigned
Jul 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2026

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 LICSW1142050 MA Primary

Addresses

Primary practice location

1 Boston Medical Ctr PL
Boston, MA 02118-2908

Mailing address

960 Massachusetts Ave Ste 2
Boston, MA 02118-2690

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251223000861 MA Practitioner - Clinical Social Worker 0749775179 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Boston University Psychiatry Associates, Inc.Group PAC ID 7911805361, 104 clinicians

Practice addresses (Care Compare)

1 Boston Medical Ctr PL
Boston, MA 02118-2908
Phone (617) 414-5245

85 E Newton St
Suite 905
Boston, MA 02118-2340
Phone (617) 414-5245

Hospital & facility affiliations

  • Boston Medical Center Hospital, Boston, MA, CCN 220031

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LICSW1142050MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Boston University Psychiatry Associates, Inc. CurrentSince Dec 15, 2025 Accepting new patients
Susan Widdicombe Therapy, PLLC Clinical Current Accepting new patients

Locations

960 Massachusetts Ave
Ste 2
Boston, MA 02118

85 East Newton St
Ste 905
Boston, MA 02118
Phone (617) 414-5245

1 Boston Medical Ctr Pl
Roxbury, MA 02118
Phone (617) 414-5245

Organizations & group practices 2

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1688688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778803200000",
    "number": "1114605375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVE STE 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BOSTON MEDICAL CTR PL",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182908",
            "telephone_number": "617-414-4145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDDICOMBE",
        "first_name": "SUSAN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-07",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "LICSW1142050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.