Individual provider Active NPI

Jacqueline Nancy Duchin, LICSW

  • Clinical Social Worker
  • Chestnut Hill, MA
National Provider Identifier
1215418009
Registry record updated Aug 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
106408 Issued in MA
Practice address
629 Hammond St Unit Eph15
Chestnut Hill, MA 02467-2167
Phone
(617) 462-4602
NPI assigned
Aug 28, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2018

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 106408 MA Primary

Addresses

Primary practice location

629 Hammond St Unit Eph15
Chestnut Hill, MA 02467-2167

Mailing address

629 Hammond St Unit Eph15
Chestnut Hill, MA 02467-2167
Phone (617) 462-4602

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

LicenseStateTypeSpecialty
106408MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1535414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1215418009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 HAMMOND ST UNIT EPH15",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024672167",
            "telephone_number": "617-462-4602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 HAMMOND ST UNIT EPH15",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024672167",
            "telephone_number": "617-462-4602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCHIN",
        "first_name": "JACQUELINE",
        "middle_name": "NANCY",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-28",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "106408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chestnut Hill, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2018; 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.