Active NPI
John Sacco, LICSW
- Clinical Social Worker
- Dorchester, MA
National Provider Identifier
1356365266
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 114812
- Practice address
- 2A Green Hill St
Dorchester, MA 02122-3515 - Phone
- (617) 602-6049
- NPI assigned
- Jul 26, 2006
- Sex
- Male
- 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 | 114812 | MA | Primary |
Addresses
Primary practice location
2A Green Hill St
Dorchester, MA 02122-3515
Mailing address
2A Green Hill St
Dorchester, MA 02122-3515
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1302272 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 114812 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1253232000000",
"number": "1356365266",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2A GREEN HILL ST",
"city": "DORCHESTER",
"state": "MA",
"postal_code": "021223515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2A GREEN HILL ST",
"city": "DORCHESTER",
"state": "MA",
"postal_code": "021223515",
"telephone_number": "617-602-6049"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SACCO",
"first_name": "JOHN",
"name_prefix": "Mr.",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2009-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "114812",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1302272",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dorchester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.