Individual provider Active NPI

Joan Kennedy Klejna

  • Clinical Social Worker
  • Brockton, MA
National Provider Identifier
1538730346
Registry record updated Jul 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
106376-SW-LICSW Issued in MA
Practice address
235 N Pearl St
Brockton, MA 02301-1794
Phone
(508) 427-2534
NPI assigned
Jul 2, 2021
Last updated
Jul 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2021

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 106376-SW-LICSW MA Primary

Addresses

Primary practice location

235 N Pearl St
Brockton, MA 02301-1794

Mailing address

253 Main St
Norfolk, MA 02056-1345
Phone (508) 528-9107

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Joan.Kennedy-Klejna@steward.org Direct Good Samaritan Medical Center, LLC

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
106376-SW-LICSWMAMDClinical Social Worker

Interoperability endpoints

  • Direct secure messaging: joan.kennedy-klejna@steward.org

NPI Registry JSON

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

{
    "created_epoch": "1625184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625184000000",
    "number": "1538730346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "253 MAIN ST",
            "city": "NORFOLK",
            "state": "MA",
            "postal_code": "020561345",
            "telephone_number": "508-528-9107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 N PEARL ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011794",
            "telephone_number": "508-427-2534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEJNA",
        "first_name": "JOAN",
        "middle_name": "KENNEDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-02",
        "last_updated": "2021-07-02",
        "certification_date": "2021-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "106376-SW-LICSW",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Joan.Kennedy-Klejna@steward.org",
            "affiliation": "Y",
            "endpointDescription": "work email",
            "affiliationName": "Good Samaritan Medical Center, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "200 Exempla Cir",
            "city": "Lafayette",
            "state": "CO",
            "country_code": "US",
            "postal_code": "800263370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2021; 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.