Individual provider Active NPI

Kerry Rumasuglia, LICSW

  • Clinical Social Worker
  • Tyngsboro, MA
National Provider Identifier
1508224049
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
118478 Issued in MA
Practice address
269 Middlesex Rd
Tyngsboro, MA 01879-1078
Phone
(978) 604-4428
NPI assigned
Jan 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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 118478 MA Primary

Addresses

Primary practice location

269 Middlesex Rd
Tyngsboro, MA 01879-1078

Mailing address

269 Middlesex Rd
Tyngsboro, MA 01879-1078

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 22, 2024 through Apr 22, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
118478MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1453939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1508224049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "269 MIDDLESEX RD",
            "city": "TYNGSBORO",
            "state": "MA",
            "postal_code": "018791078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 MIDDLESEX RD",
            "city": "TYNGSBORO",
            "state": "MA",
            "postal_code": "018791078",
            "telephone_number": "978-604-4428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUMASUGLIA",
        "first_name": "KERRY",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-28",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "118478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyngsboro, MA

Sources for this page

Verify at the official NPI Registry.