Individual provider Active NPI

Jonathan D Foote, LICSW

  • Clinical Social Worker
  • Boston, MA
National Provider Identifier
1356739734
Registry record updated Jan 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
107983 Issued in MA
Practice address
725 Albany St
5B
Boston, MA 02118-2526
Phone
(617) 414-9195
Fax
(617) 638-7472
NPI assigned
Jan 7, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2015

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 107983 MA Primary

Addresses

Primary practice location

725 Albany St
5B
Boston, MA 02118-2526

Mailing address

720 Harrison Ave
Dob 503
Boston, MA 02118-2371

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1420588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421971200000",
    "number": "1356739734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 HARRISON AVE",
            "address_2": "DOB 503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 ALBANY ST",
            "address_2": "5B",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182526",
            "telephone_number": "617-414-9195",
            "fax_number": "617-638-7472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOOTE",
        "first_name": "JONATHAN",
        "middle_name": "D",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-07",
        "last_updated": "2015-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "107983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.