Individual provider Active NPI

Beth D Haase, LICSW

  • Clinical Social Worker
  • Sharon, MA
National Provider Identifier
1366512675
Registry record updated Apr 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1021067 Issued in MA
Practice address
450 N Main St
Sharon, MA 02067-1172
Phone
(617) 962-1616
NPI assigned
Nov 8, 2006
Last updated
Apr 19, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2019

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 1021067 MA Primary

Addresses

Primary practice location

450 N Main St
Sharon, MA 02067-1172

Mailing address

450 N Main St
Sharon, MA 02067-1172
Phone (617) 962-1616

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
I20051018000984 MA Practitioner - Clinical Social Worker 3577589688 Practice locations: Sharon, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

16 Copperwood Dr
Stoughton, MA 02072-1441

161 Copperwood Dr
Stoughton, MA 02072-1441

161 Copperwood Dr
Stoughton, MA 02072-1443

450 N Main St
Sharon, MA 02067-1135
Phone (617) 962-1616

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555632000000",
    "number": "1366512675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 N MAIN ST",
            "city": "SHARON",
            "state": "MA",
            "postal_code": "020671172",
            "telephone_number": "617-962-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 N MAIN ST",
            "city": "SHARON",
            "state": "MA",
            "postal_code": "020671172",
            "telephone_number": "617-962-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAASE",
        "first_name": "BETH",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2019-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1021067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sharon, MA

Sources for this page

Verify at the official NPI Registry.