Individual provider Active NPI

Janet Susan Rustow, LICSW

  • Clinical Social Worker
  • Brookline, MA
National Provider Identifier
1346313699
Registry record updated Jun 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
105069 Issued in MA
Practice address
1330 Beacon St
Ste 349
Brookline, MA 02446-3204
Phone
(617) 688-5814
Fax
(617) 232-3044
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2016

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 105069 MA Primary

Addresses

Primary practice location

1330 Beacon St
Ste 349
Brookline, MA 02446-3204

Mailing address

14 Sacramento St
Cambridge, MA 02138-1813
Phone (617) 688-5814

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111003000104 MA Practitioner - Clinical Social Worker 8325210073 Practice locations: Brookline, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1330 Beacon St
Suite 349
Brookline, MA 02446-3204
Phone (617) 688-5814

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
105069MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464912000000",
    "number": "1346313699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 SACRAMENTO ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021381813",
            "telephone_number": "617-688-5814",
            "fax_number": "617-232-3044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 BEACON ST",
            "address_2": "STE 349",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024463204",
            "telephone_number": "617-688-5814",
            "fax_number": "617-232-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSTOW",
        "first_name": "JANET",
        "middle_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2016-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "105069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

Verify at the official NPI Registry.