Individual provider Active NPI

Risheen Brown, LICSW

  • Clinical Social Worker
  • Boston, MA
National Provider Identifier
1295045268
Registry record updated Jan 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
081998 Issued in NY
Practice address
729 Boylston St
4TH Floor
Boston, MA 02116-2639
Phone
(917) 300-9309
NPI assigned
Oct 8, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2017

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 081998 NY Primary

Addresses

Primary practice location

729 Boylston St
4TH Floor
Boston, MA 02116-2639

Mailing address

542 Massachusetts Ave
Apt 3
Boston, MA 02118-1439
Phone (978) 264-3500

Other identifiers 2

IdentifierTypeStateIssuer
1003991019OtherNYAGENCY'S NPI #
00745088OtherNYAGENCY'S MEDICAID MMIS #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Mar 17, 2022 through Mar 17, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
081998NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1286496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483920000000",
    "number": "1295045268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "542 MASSACHUSETTS AVE",
            "address_2": "APT 3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021181439",
            "telephone_number": "978-264-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "729 BOYLSTON ST",
            "address_2": "4TH FLOOR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021162639",
            "telephone_number": "917-300-9309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "RISHEEN",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-08",
        "last_updated": "2017-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "081998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AGENCY'S NPI #",
            "identifier": "1003991019",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AGENCY'S MEDICAID MMIS #",
            "identifier": "00745088",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.