NPIMap

Individual provider Active NPI

Nancy L. Kidd, LICSW

  • Clinical Social Worker
  • Lawrence, MA
National Provider Identifier
1174821375
Registry record updated Mar 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1025081 Issued in MA
Practice address
360 Merrimack St
Lawrence, MA 01843-1740
Phone
(978) 552-4472
Fax
(978) 552-4544
NPI assigned
Mar 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1025081 MA Primary
Clinical Social Worker 1041C0700X 1268 NH

Addresses

Primary practice location

360 Merrimack St
Lawrence, MA 01843-1740

Mailing address

360 Merrimack St
Lawrence, MA 01843-1740
Phone (978) 552-4472

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1268NHMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1299801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299801600000",
    "number": "1174821375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 MERRIMACK ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018431740",
            "telephone_number": "978-552-4472",
            "fax_number": "978-552-4544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 MERRIMACK ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018431740",
            "telephone_number": "978-552-4472",
            "fax_number": "978-552-4544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDD",
        "first_name": "NANCY",
        "middle_name": "L.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-11",
        "last_updated": "2011-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1025081",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "1268",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2011; 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.