Individual provider Active NPI

Heidi A Berke, LICSW

  • Clinical Social Worker
  • Bedford, MA
National Provider Identifier
1295795375
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1016749 Issued in MA
Practice address
200 Great Rd
Suite 232
Bedford, MA 01730-2711
Phone
(617) 504-6624
NPI assigned
Mar 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1016749 MA Primary

Addresses

Primary practice location

200 Great Rd
Suite 232
Bedford, MA 01730-2711

Mailing address

PO Box 750063
Arlington Heights, MA 02475-0063
Phone (617) 504-6624

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

LicenseStateTypeSpecialty
1016749MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295795375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 750063",
            "city": "ARLINGTON HEIGHTS",
            "state": "MA",
            "postal_code": "024750063",
            "telephone_number": "617-504-6624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GREAT RD",
            "address_2": "SUITE 232",
            "city": "BEDFORD",
            "state": "MA",
            "postal_code": "017302711",
            "telephone_number": "617-504-6624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERKE",
        "first_name": "HEIDI",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1016749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.