Individual provider Active NPI

Ludger Labissiere, MSW

  • Clinical Social Worker
  • Milton, MA
National Provider Identifier
1366796070
Registry record updated Nov 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
58 Dyer Ave
Milton, MA 02186-1512
Phone
(617) 678-7492
Fax
(617) 322-3904
NPI assigned
Nov 1, 2012
Last updated
Nov 1, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 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 Primary

Addresses

Primary practice location

58 Dyer Ave
Milton, MA 02186-1512

Mailing address

58 Dyer Ave
Milton, MA 02186-1512
Phone (617) 678-7492

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
I20161018000685 MA Practitioner - Clinical Social Worker 7012205446 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

225 Quincy Ave
Brockton, MA 02302-2864
Phone (888) 763-7272

695 Truman Hwy
Hyde Park, MA 02136-3552
Phone (888) 763-7272

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Outreach Wellness Center LLC CurrentSince Jun 16, 2024 Accepting new patients
Ubhs - Unlimited Behavioral Health Services Inc Clinical CurrentSince Oct 20, 2021 Accepting new patients
Tcfwc - the Child and Family Wellness Center LLC CurrentSince Sep 27, 2022 Accepting new patients
Reunited PastSince Jan 3, 2023 Accepting new patients

Locations

225 Quincy Ave
Brockton, MA 02302
Phone (508) 510-5940

1234 Hyde Park Ave
Ste 202
Hyde Park, MA 02136
Phone (617) 364-6200

695 Truman Hwy
Hyde Park, MA 02136
Phone (617) 361-1470

1354 Hancock St
Ste 205
Quincy, MA 02169
Phone (857) 939-4445

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1351728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351728000000",
    "number": "1366796070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 DYER AVE",
            "city": "MILTON",
            "state": "MA",
            "postal_code": "021861512",
            "telephone_number": "617-678-7492",
            "fax_number": "617-322-3904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 DYER AVE",
            "city": "MILTON",
            "state": "MA",
            "postal_code": "021861512",
            "telephone_number": "617-678-7492",
            "fax_number": "617-322-3904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABISSIERE",
        "first_name": "LUDGER",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-01",
        "last_updated": "2012-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milton, MA

Sources for this page

Verify at the official NPI Registry.