Active NPI
Delbert Woodham
- Clinical Social Worker
- Roxbury, MA
National Provider Identifier
1447662218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1041C0700
- Practice address
- 520 Dudley St
Roxbury, MA 02119-2769 - Phone
- (617) 331-6191
- NPI assigned
- May 28, 2014
- Sex
- Male
- 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 | 1041C0700 | MA | Primary |
Addresses
Primary practice location
520 Dudley St
Roxbury, MA 02119-2769
Mailing address
520 Dudley St
Roxbury, MA 02119-2769
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1041C0700 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401235200000",
"number": "1447662218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "520 DUDLEY ST",
"city": "ROXBURY",
"state": "MA",
"postal_code": "021192769"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 DUDLEY ST",
"city": "ROXBURY",
"state": "MA",
"postal_code": "021192769",
"telephone_number": "617-331-6191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODHAM",
"first_name": "DELBERT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-05-28",
"last_updated": "2014-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "1041C0700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roxbury, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.