Individual provider Active NPI

Alissa Susan Kuznick, LICSW

  • Clinical Social Worker
  • Medford, MA
National Provider Identifier
1164551768
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
110978 Issued in MA
Practice address
92 High St
DH7
Medford, MA 02155-3850
Phone
(781) 393-8889
Fax
(781) 396-3948
NPI assigned
Mar 2, 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
Clinical Social Worker 1041C0700X 110978 MA Primary

Addresses

Primary practice location

92 High St
DH7
Medford, MA 02155-3850

Mailing address

144 Fuller St
West Newton, MA 02465-2803
Phone (617) 795-0248

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
I20050822000282 MA Practitioner - Clinical Social Worker 2961432703 Practice locations: Newton, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

144 Fuller St
Newton, MA 02465-2803
Phone (617) 285-3435

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164551768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 FULLER ST",
            "city": "WEST NEWTON",
            "state": "MA",
            "postal_code": "024652803",
            "telephone_number": "617-795-0248",
            "fax_number": "617-795-0263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 HIGH ST",
            "address_2": "DH7",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021553850",
            "telephone_number": "781-393-8889",
            "fax_number": "781-396-3948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUZNICK",
        "first_name": "ALISSA",
        "middle_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "110978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

Verify at the official NPI Registry.