Individual provider Active NPI

Leah Bass, LICSW

  • Clinical Social Worker
  • Brookline, MA
National Provider Identifier
1346339520
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1021096 Issued in MA
Practice address
1180 Beacon St
4B
Brookline, MA 02446-3885
Phone
(617) 731-9965
Fax
(617) 731-3431
NPI assigned
Oct 12, 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 1021096 MA Primary

Addresses

Primary practice location

1180 Beacon St
4B
Brookline, MA 02446-3885

Mailing address

8 Lee Rd
Chestnut Hill, MA 02467-1325
Phone (617) 731-9965

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
I20050802000043 MA Practitioner - Clinical Social Worker 1951339837 Practice locations: Brookline, MA

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346339520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 LEE RD",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024671325",
            "telephone_number": "617-731-9965",
            "fax_number": "617-731-3431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 BEACON ST",
            "address_2": "4B",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024463885",
            "telephone_number": "617-731-9965",
            "fax_number": "617-731-3431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASS",
        "first_name": "LEAH",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1021096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

Verify at the official NPI Registry.