Samuel Alves Fonseca, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

228672 Issued in MA

Practice address

150 S Huntington Ave
Boston, MA 02130-4817

Phone

(857) 345-5660

NPI assigned

Jan 10, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 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": "1673308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1285348615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 CODMAN ST",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021244614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S HUNTINGTON AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021304817",
            "telephone_number": "857-345-5660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONSECA",
        "first_name": "SAMUEL",
        "middle_name": "ALVES",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-10",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "MA",
            "license": "228672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "VA.GOV",
            "affiliation": "N",
            "endpointDescription": "VA",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "150 S Huntington Ave",
            "city": "Boston",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021304817",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Yan Hang Fong, MBBS
• Ashfott Fonjungo, MD
• Alexandra Cristina Gomes Fonseca
• Alicia C Fonseca, CNM
• Manuel Fonseca, MSN, FNP-C
• Jeandrilie Font-Llorens
• Bronte Annette Fontaine
• Nicolette C Fontaine, MD
• Jarilis Fontanez, RN
• Edouard Fontenot, PHD

• Social Worker in Boston, MA
• Providers in Boston, MA by specialty
• Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; 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.