Individual provider Active NPI

Judith B Fox, LICSW

  • Marriage & Family Therapist
  • Stoneham, MA
National Provider Identifier
1386783249
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1029742 Issued in MA
Practice address
280 Main Street
Stoneham, MA 02180-3590
Phone
(781) 438-0038
Fax
(791) 438-2398
NPI assigned
Feb 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1029742 MA Primary

Addresses

Primary practice location

280 Main Street
Stoneham, MA 02180-3590

Mailing address

24 Union Wharf
Boston, MA 02109
Phone (617) 742-2329

Other identifiers 2

IdentifierTypeStateIssuer
P07450OtherMABLUE CROSS BLUE SHIELD
415032OtherMAVALUE OPTIONS

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
I20050804000367 MA Practitioner - Clinical Social Worker 9436188059 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Boston, MA 02109
Phone (617) 921-4322

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1029742MAMDMarriage & Family Therapist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386783249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 UNION WHARF",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02109",
            "telephone_number": "617-742-2329",
            "fax_number": "781-438-0038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 MAIN STREET",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "021803590",
            "telephone_number": "781-438-0038",
            "fax_number": "791-438-2398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "JUDITH",
        "middle_name": "B",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MA",
            "license": "1029742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "P07450",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "415032",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stoneham, MA

Sources for this page

Verify at the official NPI Registry.