Individual provider Active NPI

Cheryl R. Godbout, LICSW

  • Social Worker
  • Mattapan, MA
National Provider Identifier
1396091526
Registry record updated Jul 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
111318 Issued in MA
Practice address
1135 Morton St
Mattapan, MA 02126-2834
Phone
(617) 533-2400
Fax
(617) 533-2401
NPI assigned
Jul 25, 2012
Last updated
Jul 25, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 111318 MA Primary

Addresses

Primary practice location

1135 Morton St
Mattapan, MA 02126-2834

Mailing address

1135 Morton St
Mattapan, MA 02126-2834
Phone (617) 533-2300

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
I20200306001211 MA Practitioner - Clinical Social Worker 0648608554 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Boston University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Child and Family Psychological Services PLLCGroup PAC ID 5991763823, 260 clinicians

Practice addresses (Care Compare)

800 Turnpike St
Suite 201
North Andover, MA 01845-6156
Phone (781) 646-0500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
111318MAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Family Psychological Services, PLLC CurrentSince Mar 2, 2020 Accepting new patients

Locations

800 Turnpike St
Ste 201
North Andover, MA 01845
Phone (351) 232-2018

89 Access Rd
Ste 24
Norwood, MA 02062
Phone (781) 336-5040

169 Libbey Park
Weymouth, MA 02189
Phone (508) 238-7766

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, 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": "1343174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343174400000",
    "number": "1396091526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 MORTON ST",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021262834",
            "telephone_number": "617-533-2300",
            "fax_number": "617-533-2341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 MORTON ST",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021262834",
            "telephone_number": "617-533-2400",
            "fax_number": "617-533-2401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODBOUT",
        "first_name": "CHERYL",
        "middle_name": "R.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-25",
        "last_updated": "2012-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "111318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattapan, MA

Sources for this page

Verify at the official NPI Registry.