Nicole Bourassa-Pratt
Individual provider Active NPI Clinical Social Worker · Millbury, MA
NPI 1346678281 · NPPES record last updated Apr 4, 2023
Key facts
- NPI
- 1346678281
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 121187 (MA)
- Practice address
- 22 West St
Millbury, MA 01527-2676 - Phone
- (508) 410-4268
- NPI assigned
- Oct 30, 2013
- Sex
- Female
- Sole proprietor
- No
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2015
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
22 W St
Suite 33
Millbury, MA 01527-2676
Phone (508) 731-4198
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171122001049 | MA | Practitioner - Clinical Social Worker | 7416214770 | Practice locations: Millbury, MA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 121187 | MA | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 121187 | MA | Yes |
Addresses
Primary practice location
22 West St
Millbury, MA 01527-2676
Mailing address
17 Tiffany Cir
Millbury, MA 01527-3540
Phone (508) 410-4268
Other providers in Millbury, MA
- Blackstone Valley Acupuncture
- Blackstone Valley Home Care Specialists Inc.
- Hailee Blanchard
- Swetha Bonthu
- Barbara Borowska
- Kathy Brezenski
- Larisa Byk
- Lisa Cahill-Green
- Tiffany Caldwell
- Robert J Cavanaugh
All providers in Millbury, MA · Clinical Social Worker in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 4, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.