Individual provider Active NPI

Judith A Bolandz, LCSW, MED

  • Clinical Social Worker
  • Jamaica Plain, MA
National Provider Identifier
1609919752
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
203109 Issued in MA
Practice address
157 Green St
Jamaica Plain, MA 02130-2667
Phone
(617) 983-5800
NPI assigned
Feb 15, 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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 203109 MA Primary

Addresses

Primary practice location

157 Green St
Jamaica Plain, MA 02130-2667

Mailing address

36 Payson St
Attleboro, MA 02703-1612
Phone (508) 222-7278

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
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
203109MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609919752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 PAYSON ST",
            "city": "ATTLEBORO",
            "state": "MA",
            "postal_code": "027031612",
            "telephone_number": "508-222-7278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 GREEN ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021302667",
            "telephone_number": "617-983-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLANDZ",
        "first_name": "JUDITH",
        "middle_name": "A",
        "credential": "LCSW, MED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "203109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica Plain, 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.