Individual provider Active NPI

Kellie Foxx-Gonzalez

  • Social Worker
  • Brookline, MA
National Provider Identifier
1164197158
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
1788 Beacon St Apt 5a
Brookline, MA 02445-2046
Phone
(561) 246-7097
NPI assigned
Aug 11, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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 Primary

Addresses

Primary practice location

1788 Beacon St Apt 5a
Brookline, MA 02445-2046

Mailing address

1788 Beacon St Apt 5a
Brookline, MA 02445-2046
Phone (561) 246-7097

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

NPI Registry JSON

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

{
    "created_epoch": "1628640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1164197158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1788 BEACON ST APT 5A",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024452046",
            "telephone_number": "561-246-7097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1788 BEACON ST APT 5A",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024452046",
            "telephone_number": "561-246-7097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOXX-GONZALEZ",
        "first_name": "KELLIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-11",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "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 Aug 11, 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.