Active NPI
Gabrielle Cavallacci, LICSW
- Clinical Social Worker
- Brookline, MA
National Provider Identifier
1326161944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1024295
- Practice address
- 1415 Beacon St
Brookline, MA 02446-4816 - Phone
- (617) 566-2200
- NPI assigned
- Apr 9, 2007
- Last updated
- Jul 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 | 1024295 | MA | Primary |
Addresses
Primary practice location
1415 Beacon St
Brookline, MA 02446-4816
Mailing address
33 Longwood Ave
Apt 1
Brookline, MA 02446-5239
Phone (617) 731-5857
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1854348 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Previously, effective Aug 27, 2020 through Aug 27, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1326161944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 LONGWOOD AVE",
"address_2": "APT 1",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024465239",
"telephone_number": "617-731-5857"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1415 BEACON ST",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024464816",
"telephone_number": "617-566-2200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAVALLACCI",
"first_name": "GABRIELLE",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "1024295",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1854348",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brookline, 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.