Individual provider Active NPI

Kristin Ross, LICSW

  • Clinical Social Worker
  • Hingham, MA
National Provider Identifier
1174921662
Registry record updated Apr 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
120614 Issued in MA
Practice address
160 Old Derby St Ste 338
Hingham, MA 02043-4062
Phone
(781) 424-5382
Fax
(508) 224-4797
NPI assigned
Dec 15, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Clinical Social Worker 1041C0700X 120614 MA Primary

Addresses

Primary practice location

160 Old Derby St Ste 338
Hingham, MA 02043-4062

Mailing address

160 Old Derby St Ste 338
Hingham, MA 02043-4062
Phone (781) 424-5382

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
I20171010001973 MA Practitioner - Clinical Social Worker 7618242132 Practice locations: Hingham, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

160 Old Derby St
Suite 377
Hingham, MA 02043-4062
Phone (781) 783-4701

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
120614MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1418601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681603200000",
    "number": "1174921662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 OLD DERBY ST STE 338",
            "city": "HINGHAM",
            "state": "MA",
            "postal_code": "020434062",
            "telephone_number": "781-424-5382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 OLD DERBY ST STE 338",
            "city": "HINGHAM",
            "state": "MA",
            "postal_code": "020434062",
            "telephone_number": "781-424-5382",
            "fax_number": "508-224-4797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "KRISTIN",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-15",
        "last_updated": "2023-04-16",
        "certification_date": "2023-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "120614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hingham, MA

Sources for this page

Verify at the official NPI Registry.