Individual provider Active NPI

Jane Frances Broderick-Danforth, L.I.C.S.W.

  • Clinical Social Worker
  • Norwood, MA
National Provider Identifier
1609806322
Registry record updated Nov 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1023151 Issued in MA
Practice address
1 Walpole St
Norwood, MA 02062-3315
Phone
(508) 238-7766
Fax
(508) 230-5089
NPI assigned
Jul 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2016

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 1023151 MA Primary

Addresses

Primary practice location

1 Walpole St
Norwood, MA 02062-3315

Mailing address

1 Walpole St
Norwood, MA 02062-3315
Phone (781) 695-2630

Other identifiers 2

IdentifierTypeStateIssuer
494539OtherMATUFTS HEALTH PLAN
P08599OtherMABC BS OF MASSACHUSETTS

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
I20050224000808 MA Practitioner - Clinical Social Worker 6406809946 Practice locations: Westwood, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

14 Eastman Ave
Westwood, MA 02090-2809
Phone (781) 695-2630

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Associates of Southeastern Massachusetts, LLC Clinical PastSince Feb 1, 2012 Accepting new patients
Child and Family Psychological Services, PLLC Clinical Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478217600000",
    "number": "1609806322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WALPOLE ST",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020623315",
            "telephone_number": "781-695-2630",
            "fax_number": "781-769-7008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WALPOLE ST",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020623315",
            "telephone_number": "508-238-7766",
            "fax_number": "508-230-5089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODERICK-DANFORTH",
        "first_name": "JANE",
        "middle_name": "FRANCES",
        "credential": "L.I.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2016-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1023151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "494539",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS OF MASSACHUSETTS",
            "identifier": "P08599",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwood, MA

Sources for this page

Verify at the official NPI Registry.