Active NPI
James John Butrym, LICSW
- Clinical Social Worker
- Worcester, MA
National Provider Identifier
1265460588
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 114294
- Practice address
- 5 Tatnuck GDNS
Worcester, MA 01602-1220 - Phone
- (508) 798-8305
- NPI assigned
- Jun 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 114294 | MA | Primary |
Addresses
Primary practice location
5 Tatnuck GDNS
Worcester, MA 01602-1220
Mailing address
55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 856-5944
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| JB57349 | Medicaid | RI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 114294 | MA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Providence Center Inc | Clinical | Past | Accepting new patients |
| The Providence Center | 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.
-
- Community/Behavioral Health Agency
- Providence, RI
- NPI 1134977598
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Providence, RI
- NPI 1104847946
Clinical
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204588800000",
"number": "1265460588",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 LAKE AVE N",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016550002",
"telephone_number": "508-856-5944"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 TATNUCK GDNS",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016021220",
"telephone_number": "508-798-8305"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTRYM",
"first_name": "JAMES",
"middle_name": "JOHN",
"name_prefix": "Mr.",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-28",
"last_updated": "2008-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "114294",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "JB57349",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.