Individual provider Active NPI

Kristen Kohlmeyer

  • Clinical Social Worker
  • Needham, MA
National Provider Identifier
1295044055
Registry record updated Sep 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
114322 Issued in MA
Practice address
237 Highland Ave
Riverside Community Service Agency
Needham, MA 02494-3036
Phone
(781) 433-0672
NPI assigned
Sep 28, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2010

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 114322 MA Primary

Addresses

Primary practice location

237 Highland Ave
Riverside Community Service Agency
Needham, MA 02494-3036

Mailing address

237 Highland Ave
Riverside Community Service Agency
Needham, MA 02494-3036
Phone (781) 433-0672

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
114322MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1285632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285632000000",
    "number": "1295044055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 HIGHLAND AVE",
            "address_2": "RIVERSIDE COMMUNITY SERVICE AGENCY",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024943036",
            "telephone_number": "781-433-0672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 HIGHLAND AVE",
            "address_2": "RIVERSIDE COMMUNITY SERVICE AGENCY",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024943036",
            "telephone_number": "781-433-0672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHLMEYER",
        "first_name": "KRISTEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-28",
        "last_updated": "2010-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "114322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Needham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2010; 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.