Individual provider Active NPI

Brian C Pitts, LICSW

  • Clinical Social Worker
  • Weymouth, MA
National Provider Identifier
1255411641
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1022646 Issued in MA
Practice address
169 Libbey Industrial Pkwy
2ND Floor
Weymouth, MA 02189-3101
Phone
(781) 682-1060
Fax
(781) 682-1061
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1022646 MA Primary

Addresses

Primary practice location

169 Libbey Industrial Pkwy
2ND Floor
Weymouth, MA 02189-3101

Mailing address

169 Libbey Industrial Pkwy
2ND Floor
Weymouth, MA 02189-3101
Phone (781) 682-1060

Other identifiers 1

IdentifierTypeStateIssuer
P06963OtherMABCBS PROVIDER NUMBER

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1022646MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Neurobehavioral Associates III, Inc Clinical PastSince May 25, 1999 Accepting new patients
Mashpee Mental Health Center, Inc. Past Accepting new patients

Organizations & group practices 2

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255411641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 LIBBEY INDUSTRIAL PKWY",
            "address_2": "2ND FLOOR",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021893101",
            "telephone_number": "781-682-1060",
            "fax_number": "781-682-1061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 LIBBEY INDUSTRIAL PKWY",
            "address_2": "2ND FLOOR",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021893101",
            "telephone_number": "781-682-1060",
            "fax_number": "781-682-1061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITTS",
        "first_name": "BRIAN",
        "middle_name": "C",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1022646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "P06963",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Weymouth, MA

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.