Kimberly C Fantini, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

000121351 Issued in MA

Practice address

49 Stony Brook Rd
Westford, MA 01886-1903

Phone

(978) 697-1808

NPI assigned

Jul 20, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Holistic Behavioral Health Multi Services LLCGroup PAC ID 4688044225, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Holistic Behavioral Health Multi Services PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Woburn, MA
  • NPI 1144956194
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1532044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532044800000",
    "number": "1356828578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 STONY BROOK RD",
            "city": "WESTFORD",
            "state": "MA",
            "postal_code": "018861903",
            "telephone_number": "978-697-1808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 STONY BROOK RD",
            "city": "WESTFORD",
            "state": "MA",
            "postal_code": "018861903",
            "telephone_number": "978-697-1808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANTINI",
        "first_name": "KIMBERLY",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-20",
        "last_updated": "2018-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "000121351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Nicole Fallis, PA-C
• Family Eye Care Center & Optical Gallery Inc.
• Family Eye Care Center & Optical Gallery Inc.
• Family Eye Care Center & Optical Gallery, Inc.
• Family Eye Care Center & Optical Gallery, LLC
• Feccog Lowell LLC
• Meghan Grace Feeley, APRN, NP-C
• Arthur S Fergusson
• Nichole T Finn, MS, OTR/L
• Stephen Cobb Fisher, PHD

• Clinical Social Worker in Westford, MA
• Providers in Westford, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.