Lerato Vilakazi-Jackson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

220967 Issued in MA

Practice address

548 Park Ave Ste B
Worcester, MA 01603-2537

Phone

(774) 823-1500

Fax

(774) 823-1481

NPI assigned

Oct 9, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Boston Neurobehavioral Associates, LLC

  • Psychiatry Physician
  • New Bedford, MA
  • NPI 1558415307
  Medicare reassignment NPD

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

{
    "created_epoch": "1507507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1154831741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SOUTH BAY EARLY CHILDHOOD",
            "address_2": "548 PARK AVE SUITE B",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016032537",
            "telephone_number": "774-823-1500",
            "fax_number": "774-823-1481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "548 PARK AVE STE B",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016032537",
            "telephone_number": "774-823-1500",
            "fax_number": "774-823-1481"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "South Bay Mental Health Services",
            "address_2": "548 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "01603",
            "country_code": "US",
            "telephone_number": "774-823-1451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILAKAZI-JACKSON",
        "first_name": "LERATO",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-09",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "220967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Libenyi Vidal
• Erez Vidan, M.D.
• Sai Sanjana Vietla, DO
• Fnu Vijaya Prakash Aviraag, MD
• Gopal R Vijayaraghavan, M.D.
• Vanessa I. Vilas
• Abel Vilcapoma, D.MIN.
• Emily Victoria Vilk
• Odalid Villalobos
• Lisbey Villamil-Castillo, M.A.

• Clinical Social Worker in Worcester, MA
• Providers in Worcester, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.