Individual provider Active NPI

Joel Krieg, LICSW

  • Clinical Social Worker
  • Cambridge, MA
National Provider Identifier
1215256201
Registry record updated Dec 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
115659 Issued in MA
Practice address
10 Concord Ave
Cambridge, MA 02138-2322
Phone
(617) 682-0057
NPI assigned
May 31, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2016

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 115659 MA Primary

Addresses

Primary practice location

10 Concord Ave
Cambridge, MA 02138-2322

Mailing address

10 Concord Ave
Cambridge, MA 02138-2322
Phone (617) 682-0057

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
I20110415000195 MA Practitioner - Clinical Social Worker 7113101163 Reassigns benefits to 1 organization
Practice locations: Cambridge, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brookline Community Mental Health Center IncGroup PAC ID 9032181433, 27 clinicians

Practice addresses (Care Compare)

10 Concord Ave
Cambridge, MA 02138-2322
Phone (617) 682-0057

43 Garrison Rd
Brookline, MA 02445-4445

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brookline Community Mental Health Center Inc. CurrentSince May 20, 2022 Accepting new patients

Locations

43 Garrison Rd
Brookline, MA 02445
Phone (617) 277-8107

Organizations & group practices 1

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": "1275264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480636800000",
    "number": "1215256201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CONCORD AVE",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021382322",
            "telephone_number": "617-682-0057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CONCORD AVE",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021382322",
            "telephone_number": "617-682-0057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRIEG",
        "first_name": "JOEL",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-31",
        "last_updated": "2016-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "115659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.