Active NPI
Laurie E Hackett, M.S.W., L.I.C.S.W.
- Clinical Social Worker
- Newton Highlands, MA
National Provider Identifier
1316095151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 104762
- Practice address
- 30 Lincoln St
Newton Highlands, MA 02461-1527 - Phone
- (617) 512-6264
- NPI assigned
- Jan 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 104762 | MA | Primary |
Addresses
Primary practice location
30 Lincoln St
Newton Highlands, MA 02461-1527
Mailing address
28 Floral St
Newton, MA 02461-1245
Phone (617) 512-6264
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 15, 2021 through Feb 15, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104762 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613606400000",
"number": "1316095151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 FLORAL ST",
"city": "NEWTON",
"state": "MA",
"postal_code": "024611245",
"telephone_number": "617-512-6264"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 LINCOLN ST",
"city": "NEWTON HIGHLANDS",
"state": "MA",
"postal_code": "024611527",
"telephone_number": "617-512-6264"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HACKETT",
"first_name": "LAURIE",
"middle_name": "E",
"credential": "M.S.W., L.I.C.S.W.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-08",
"last_updated": "2021-02-18",
"certification_date": "2021-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "104762",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newton Highlands, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.