Individual provider Active NPI

Victoria Kinniard

  • Clinical Social Worker
  • Boston, MA
National Provider Identifier
1447708763
Registry record updated Sep 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
221911 Issued in MA
Practice address
418 Commonwealth Ave
Boston, MA 02215-2801
Phone
(617) 785-8693
NPI assigned
Sep 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2016

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 221911 MA Primary

Addresses

Primary practice location

418 Commonwealth Ave
Boston, MA 02215-2801

Mailing address

32 Glenville Ave Apt 1
Allston, MA 02134-3507
Phone (630) 336-9211

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

LicenseStateTypeSpecialty
221911MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1473897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473897600000",
    "number": "1447708763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 GLENVILLE AVE APT 1",
            "city": "ALLSTON",
            "state": "MA",
            "postal_code": "021343507",
            "telephone_number": "630-336-9211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 COMMONWEALTH AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022152801",
            "telephone_number": "617-785-8693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINNIARD",
        "first_name": "VICTORIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-15",
        "last_updated": "2016-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "221911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.