Individual provider Active NPI

Valerie Thibault, MSW, LCSW

  • Clinical Social Worker
  • Brookline, MA
National Provider Identifier
1154084168
Registry record updated Oct 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
225189 Issued in MA
Practice address
200 Ivy St
Brookline, MA 02446-3907
Phone
(617) 732-0260
NPI assigned
Oct 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X 511915 MA
Clinical Social Worker 1041C0700X 225189 MA Primary

Addresses

Primary practice location

200 Ivy St
Brookline, MA 02446-3907

Mailing address

55 Lincoln St Apt 34
Malden, MA 02148-2551
Phone (508) 216-6887

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
225189MAMDClinical Social Worker
511915MAMDSchool Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1634428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634428800000",
    "number": "1154084168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 LINCOLN ST APT 34",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021482551",
            "telephone_number": "508-216-6887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 IVY ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024463907",
            "telephone_number": "617-732-0260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBAULT",
        "first_name": "VALERIE",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-17",
        "last_updated": "2021-10-17",
        "certification_date": "2021-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "MA",
            "license": "511915",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "225189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2021; 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.