Individual provider Active NPI

Cheryl Litt, LICSW BCD

  • Clinical Social Worker
  • Brockton, MA
National Provider Identifier
1356427264
Registry record updated Dec 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
103344 Issued in MA
Practice address
1350 Belmont St
Ste 107
Brockton, MA 02301-4430
Phone
(508) 586-1600
NPI assigned
Oct 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2012

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 103344 MA Primary

Addresses

Primary practice location

1350 Belmont St
Ste 107
Brockton, MA 02301-4430

Mailing address

1350 Belmont St
Ste 107
Brockton, MA 02301-4430
Phone (508) 586-1600

Other identifiers 9

IdentifierTypeStateIssuer
095063OtherMHN
052600000OtherMAGELLAN MIS NUMBER
0004131865OtherAETNA
LIP01899OtherMABCBS
899601OtherHARVARD PILGRIM
780065OtherTUFTS
88040OtherCIGNA
014698OtherVALUE OPTIONS
665712OtherTUFTS

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
I20050922000840 MA Practitioner - Clinical Social Worker 6103850763 Practice locations: Brockton, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1342 Belmont St
Suite 103
Brockton, MA 02301-4437
Phone (508) 586-1600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
103344MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356566400000",
    "number": "1356427264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 BELMONT ST",
            "address_2": "STE 107",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014430",
            "telephone_number": "508-586-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 BELMONT ST",
            "address_2": "STE 107",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014430",
            "telephone_number": "508-586-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITT",
        "first_name": "CHERYL",
        "credential": "LICSW BCD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2012-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "103344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "095063",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN MIS NUMBER",
            "identifier": "052600000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0004131865",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "LIP01899",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "899601",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "780065",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "88040",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "014698",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "665712",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.