Lisa Jennette Du Breuil, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

113068 Issued in MA

Practice address

16 Blossom St
First Floor
Boston, MA 02114-3104

Phone

(617) 724-4903

Fax

(617) 248-0070

NPI assigned

Apr 24, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205055605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 BLOSSOM ST",
            "address_2": "FIRST FLOOR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021143104",
            "telephone_number": "617-724-4903",
            "fax_number": "617-248-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 BLOSSOM ST",
            "address_2": "FIRST FLOOR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021143104",
            "telephone_number": "617-724-4903",
            "fax_number": "617-248-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DU BREUIL",
        "first_name": "LISA",
        "middle_name": "JENNETTE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "113068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dan Michael Drzymalski, M.D.
• DSM USA Insurance Company, Inc.
• Jeanne Maria Dsouza, MBBS
• Sandria Ann Dsouza, M.D.
• DTG II PLLC (BeyondMD)
• Amy Du
• Elizabeth Hai Yen Du, M.D.
• Hillary Ann Du
• Jennifer Jingyi Du
• Leanne Lei Du, MBBS,

• Clinical Social Worker in Boston, MA
• Providers in Boston, 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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.