Active NPI
Karen Putter Short, LICSW
- Clinical Social Worker
- Westford, MA
National Provider Identifier
1366512501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 105882
- Practice address
- 254 Littleton Rd
Karendyth
Westford, MA 01886-3519 - Phone
- (978) 266-9100
- Fax
- (978) 268-5089
- NPI assigned
- Nov 8, 2006
- Sex
- Female
- 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 | 105882 | MA | Primary |
Addresses
Primary practice location
254 Littleton Rd
Karendyth
Westford, MA 01886-3519
Mailing address
PO Box 2846
Acton, MA 01720-6846
Phone (978) 266-9100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PO4265 | Other | MA | BCBS PROVIDER ID NUMBER |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 105882 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1366512501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2846",
"city": "ACTON",
"state": "MA",
"postal_code": "017206846",
"telephone_number": "978-266-9100",
"fax_number": "978-268-5089"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "254 LITTLETON RD",
"address_2": "KARENDYTH",
"city": "WESTFORD",
"state": "MA",
"postal_code": "018863519",
"telephone_number": "978-266-9100",
"fax_number": "978-268-5089"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHORT",
"first_name": "KAREN",
"middle_name": "PUTTER",
"name_prefix": "Mrs.",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "105882",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER ID NUMBER",
"identifier": "PO4265",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Westford, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.