Active NPI
Judith W Semonoff, LICSW
- Clinical Social Worker
- Waltham, MA
National Provider Identifier
1295751881
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- ISW01351
- Practice address
- 1430 Main St
Waltham, MA 02451-1623 - Phone
- (781) 647-5327
- NPI assigned
- Jul 15, 2006
- Last updated
- Mar 20, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 115688 | MA | |
| Clinical Social Worker | 1041C0700X | ISW01351 | RI | Primary |
Addresses
Primary practice location
1430 Main St
Waltham, MA 02451-1623
Mailing address
33 Hilltop Ave
Barrington, RI 02806-3515
Phone (401) 339-4560
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6400144 | Other | RI | EI UHP |
| 292177 | Other | RI | EI BCROSS |
| 412296 | Other | RI | EI BCHIP |
| 2092 | Other | RI | EI NHPRC |
| ES01788 | 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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 115688 | MA | MD | Clinical Social Worker |
| ISW01351 | RI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521504000000",
"number": "1295751881",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 HILLTOP AVE",
"city": "BARRINGTON",
"state": "RI",
"postal_code": "028063515",
"telephone_number": "401-339-4560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1430 MAIN ST",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024511623",
"telephone_number": "781-647-5327"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEMONOFF",
"first_name": "JUDITH",
"middle_name": "W",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-15",
"last_updated": "2018-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "115688",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "RI",
"license": "ISW01351",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EI UHP",
"identifier": "6400144",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EI BCROSS",
"identifier": "292177",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EI BCHIP",
"identifier": "412296",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EI NHPRC",
"identifier": "2092",
"state": "RI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ES01788",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waltham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.