Individual provider Active NPI

Amy Jeanne Garber

  • Clinical Social Worker
  • Waltham, MA
National Provider Identifier
1447735592
Registry record updated Sep 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1155168 Issued in MA
Practice address
375 Totten Pond Rd Ste 100
Waltham, MA 02451-2026
Phone
(781) 419-1330
NPI assigned
Sep 25, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 115168 MA
Clinical Social Worker 1041C0700X 1155168 MA Primary

Addresses

Primary practice location

375 Totten Pond Rd Ste 100
Waltham, MA 02451-2026

Mailing address

18 Village Gate Rd
Canton, MA 02021-2432
Phone (617) 312-9244

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
115168MAMDClinical Social Worker
1155168MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1537833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537833600000",
    "number": "1447735592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 VILLAGE GATE RD",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020212432",
            "telephone_number": "617-312-9244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 TOTTEN POND RD STE 100",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024512026",
            "telephone_number": "781-419-1330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARBER",
        "first_name": "AMY",
        "middle_name": "JEANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-25",
        "last_updated": "2018-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "115168",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1155168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2018; 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.