Active NPI
Carl Anthony Aveni, MSW LICSW
- Clinical Social Worker
- Brockton, MA
National Provider Identifier
1174637086
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- MA 100612
- Practice address
- 940 Belmont St
Ward 2-3-C
Brockton, MA 02301-5596 - Phone
- (774) 826-1347
- Fax
- (774) 826-3158
- NPI assigned
- Aug 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | MA 100612 | MA | Primary |
Addresses
Primary practice location
940 Belmont St
Ward 2-3-C
Brockton, MA 02301-5596
Mailing address
89 Manners Ave
Brockton, MA 02301-1420
Phone (508) 584-4734
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100612 | Other | MA | STATE SOCIAL WORK LICENSE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA 100612 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174637086",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "89 MANNERS AVE",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023011420",
"telephone_number": "508-584-4734"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "940 BELMONT ST",
"address_2": "WARD 2-3-C",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023015596",
"telephone_number": "774-826-1347",
"fax_number": "774-826-3158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVENI",
"first_name": "CARL",
"middle_name": "ANTHONY",
"name_prefix": "Mr.",
"credential": "MSW LICSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "MA 100612",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE SOCIAL WORK LICENSE",
"identifier": "100612",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brockton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.