Jo-Ann Venezia Phillips, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

116231 Issued in MA

Practice address

165 Main St Unit 205
Medway, MA 02053-1584

Phone

(978) 304-9283

NPI assigned

May 12, 2008

Last updated

Sep 16, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Heart Stone Counseling Services LLC

  • Mental Health Counselor
  • Medway, MA
  • NPI 1760153092
  NPD Authorized official
• SB Transitional Sub, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brockton, MA
  • NPI 1962091173
  NPD (past)
• South Bay Mental Health Center, Inc.

  dba South Bay Community Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brockton, MA
  • NPI 1023096864
  NPD (past)

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

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1568639375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 MAIN ST UNIT 205",
            "city": "MEDWAY",
            "state": "MA",
            "postal_code": "020531584",
            "telephone_number": "978-304-9283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 MAIN ST UNIT 205",
            "city": "MEDWAY",
            "state": "MA",
            "postal_code": "020531584",
            "telephone_number": "978-304-9283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENEZIA PHILLIPS",
        "first_name": "JO-ANN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-12",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "116231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSACHUSETTS STATE LICENSING BOARD OF SOCIAL WORKERS",
            "identifier": "116231",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristine Touhey, PHARMD
• Town of Medway
• Town of Medway
• Trauma to Hope Counseling Corp (Trauma to Hope Counseling Services)
• Amy Varnerin, CCC SLP
• Walgreen Co (Walgreens #06939)
• Ann Waithera Wanderi, NP
• Waves Counseling Services LLC
• Waves Within Wellness
• Jessica Jackson Weed, NP

• Clinical Social Worker in Medway, MA
• Providers in Medway, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.