Bonnie Jo Engelhardt, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

102678 Issued in MA

Practice address

36 Walnut Court
Stoughton, MA 02072

Phone

(781) 444-7405

NPI assigned

Feb 8, 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255471991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 WALNUT COURT",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "02072",
            "telephone_number": "781-344-0244",
            "fax_number": "617-969-9934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 WALNUT COURT",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "02072",
            "telephone_number": "781-444-7405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGELHARDT",
        "first_name": "BONNIE",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "102678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "ENPO1706",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Stoughton, MA
• Providers in Stoughton, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.