Individual provider Active NPI

Sally Brecher, MSW, LICSW

  • Clinical Social Worker
  • West Newton, MA
National Provider Identifier
1588720668
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
101043 Issued in MA
Practice address
91 Hillside Ave
West Newton, MA 02465-2546
Phone
(617) 332-9797
Fax
(617) 332-9797
NPI assigned
Dec 31, 2006
Sex
Female
Sole proprietor
Yes

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 101043 MA Primary

Addresses

Primary practice location

91 Hillside Ave
West Newton, MA 02465-2546

Mailing address

91 Hillside Ave
West Newton, MA 02465-2546
Phone (617) 332-9797

Other identifiers 1

IdentifierTypeStateIssuer
PO1476OtherMABLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090924000517 MA Practitioner - Clinical Social Worker 2961558432 Practice locations: West Newton, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

91 Hillside Ave
West Newton, MA 02465-2546
Phone (617) 332-9797

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1167523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588720668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 HILLSIDE AVE",
            "city": "WEST NEWTON",
            "state": "MA",
            "postal_code": "024652546",
            "telephone_number": "617-332-9797",
            "fax_number": "617-332-9797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 HILLSIDE AVE",
            "city": "WEST NEWTON",
            "state": "MA",
            "postal_code": "024652546",
            "telephone_number": "617-332-9797",
            "fax_number": "617-332-9797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRECHER",
        "first_name": "SALLY",
        "name_prefix": "Mrs.",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "101043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "PO1476",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Newton, MA

Sources for this page

Verify at the official NPI Registry.