Individual provider Active NPI

Gay R Vervaet, LICSW

  • Clinical Social Worker
  • Cambridge, MA
National Provider Identifier
1528275526
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1019762 Issued in MA
Practice address
127 Mt Auburn St
Cambridge, MA 02138
Phone
(617) 354-6770
Fax
(617) 354-6770
NPI assigned
May 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1019762 MA Primary
Clinical Social Worker 1041C0700X 27511 MA

Addresses

Primary practice location

127 Mt Auburn St
Cambridge, MA 02138

Mailing address

339 Harvard St
Cambridge, MA 02139
Phone (617) 354-4886

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
1019762MAMDClinical Social Worker
27511MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528275526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 HARVARD ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "02139",
            "telephone_number": "617-354-4886",
            "fax_number": "617-354-6770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 MT AUBURN ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "02138",
            "telephone_number": "617-354-6770",
            "fax_number": "617-354-6770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERVAET",
        "first_name": "GAY",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1019762",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "27511",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.