Nicholas Packard, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

000123275 Issued in MA

Practice address

69 Union St Ste 1
Newton, MA 02459-2252

Phone

(617) 778-4942

NPI assigned

Feb 12, 2018

Last updated

Feb 14, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1518393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1164921516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 WASHINGTON ST APT 6",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024466130",
            "telephone_number": "857-919-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 UNION ST STE 1",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024592252",
            "telephone_number": "617-778-4942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACKARD",
        "first_name": "NICHOLAS",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-12",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "224356",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "000123275",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sotheara Ouk
• Our Family Circle, LLC
• Mackenzie M Owades, MS, OTR/L
• Rodney Allen Owens Sr.
• Gregory F. Oxenkrug, M.D.
• Judith Gilmartin Packer, M.D.
• Marsha A Padwa, PSY D
• Boyoung Paik
• Lynn Paikowsky, MD
• Cecily Paine

• Clinical Social Worker in Newton, MA
• Providers in Newton, 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 Feb 14, 2024; 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.