Individual provider Active NPI

Deborah Bluestone, LICSW

  • Clinical Social Worker
  • Boston, MA
National Provider Identifier
1144438227
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
105204 Issued in MA
Practice address
877 Beacon St
Boston, MA 02215-3801
Phone
(617) 369-7779
NPI assigned
May 20, 2007
Last updated
Jul 8, 2007By the provider in NPPES
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
Clinical Social Worker 1041C0700X 105204 MA Primary

Addresses

Primary practice location

877 Beacon St
Boston, MA 02215-3801

Mailing address

877 Beacon St
Boston, MA 02215-3801
Phone (617) 369-7779

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 15, 2024 through Jul 15, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
105204MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1179619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144438227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "877 BEACON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022153801",
            "telephone_number": "617-369-7779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "877 BEACON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022153801",
            "telephone_number": "617-369-7779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUESTONE",
        "first_name": "DEBORAH",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "105204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.