Individual provider Active NPI

Judith L Lischetti, LICSW

  • Social Worker
  • Jamaica Plain, MA
National Provider Identifier
1124147558
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
1018380 Issued in MA
Practice address
3297 Washington St
Jamaica Plain, MA 02130-2655
Phone
(617) 983-6018
Fax
(617) 983-6069
NPI assigned
Mar 28, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1018380 MA Primary

Addresses

Primary practice location

3297 Washington St
Jamaica Plain, MA 02130-2655

Mailing address

3297 Washington St
Jamaica Plain, MA 02130-2655
Phone (617) 983-6018

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
I20190521002730 MA Practitioner - Clinical Social Worker 5799028403 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1018380MAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham & Womens Hospital, Inc. CurrentSince May 1, 2019 Accepting new patients

Locations

75 Francis St
Boston, MA 02115

375 Boylston St
Brookline, MA 02445
Phone (508) 718-4010

399 Revolution Dr
Somerville, MA 02145
Phone (800) 856-1983

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": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124147558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3297 WASHINGTON ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021302655",
            "telephone_number": "617-983-6018",
            "fax_number": "617-983-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3297 WASHINGTON ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021302655",
            "telephone_number": "617-983-6018",
            "fax_number": "617-983-6069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISCHETTI",
        "first_name": "JUDITH",
        "middle_name": "L",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "1018380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica Plain, MA

Sources for this page

Verify at the official NPI Registry.