Individual provider Active NPI

Joyce B Keohan, LICSW

  • Clinical Social Worker
  • Kingston, MA
National Provider Identifier
1174539902
Registry record updated Apr 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
105902 Issued in MA
Practice address
62 Main St
Kingston, MA 02364-3046
Phone
(781) 585-9300
Fax
(781) 585-9302
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2015

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 105902 MA Primary

Addresses

Primary practice location

62 Main St
Kingston, MA 02364-3046

Mailing address

62 Main St
Kingston, MA 02364-3046
Phone (781) 585-9300

Other identifiers 6

IdentifierTypeStateIssuer
228395OtherMAMHN/CHAMPUS
800012152OtherMARAILROAD MEDICARE
164420000OtherMAMAGELLAN
2099770OtherMACIGNA
426056OtherMAHARVARD/PILGRIM
PO44O8OtherMABLUE CROSS

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
I20051014000306 MA Practitioner - Clinical Social Worker 2860417250 Reassigns benefits to 1 organization
Practice locations: Kingston, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

62 Main St
Suite 206
Kingston, MA 02364-3071
Phone (781) 585-9300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
South Shore Mental Health Center, Inc. CurrentSince Jul 17, 1995 Accepting new patients
Bridgewater Square Chiropractic Inc. PastSince May 11, 1998 Accepting new patients

Locations

1501 Washington St
Braintree, MA 02184
Phone (617) 745-2709

64 Industrial Park Rd
Plymouth, MA 02360
Phone (508) 747-2012

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428019200000",
    "number": "1174539902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 MAIN ST",
            "city": "KINGSTON",
            "state": "MA",
            "postal_code": "023643046",
            "telephone_number": "781-585-9300",
            "fax_number": "781-585-9302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 MAIN ST",
            "city": "KINGSTON",
            "state": "MA",
            "postal_code": "023643046",
            "telephone_number": "781-585-9300",
            "fax_number": "781-585-9302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEOHAN",
        "first_name": "JOYCE",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2015-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "105902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN/CHAMPUS",
            "identifier": "228395",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "800012152",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "164420000",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2099770",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD/PILGRIM",
            "identifier": "426056",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "PO44O8",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, MA

Sources for this page

Verify at the official NPI Registry.