Individual provider Active NPI

Margery Cohen-Jacoby

  • Clinical Social Worker
  • Brockton, MA
National Provider Identifier
1235640541
Registry record updated Oct 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
104616 Issued in MA
Practice address
839 Pleasant St
Brockton, MA 02301-3076
Phone
(781) 724-4284
NPI assigned
Oct 14, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 104616 MA Primary

Addresses

Primary practice location

839 Pleasant St
Brockton, MA 02301-3076

Mailing address

234 Walpole St
Sharon, MA 02067-1626
Phone (781) 724-4284

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
I20050825000531 MA Practitioner - Clinical Social Worker 0547291940 Practice locations: East Bridgewater, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

36 N Bedford St
East Bridgewater, MA 02333-1186
Phone (781) 724-4284

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
104616MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1507939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507939200000",
    "number": "1235640541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 WALPOLE ST",
            "city": "SHARON",
            "state": "MA",
            "postal_code": "020671626",
            "telephone_number": "781-724-4284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "839 PLEASANT ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023013076",
            "telephone_number": "781-724-4284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN-JACOBY",
        "first_name": "MARGERY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-14",
        "last_updated": "2017-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "104616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.