Individual provider Active NPI

Sandra Woodburn-Blocker, LICSW

  • Clinical Social Worker
  • Westford, MA
National Provider Identifier
1639652001
Registry record updated Sep 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
107613-SW-LICSW Issued in MA
Practice address
2 Applewood Dr
Westford, MA 01886-3629
Phone
(978) 857-6472
NPI assigned
Sep 12, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2018

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 107613-SW-LICSW MA Primary

Addresses

Primary practice location

2 Applewood Dr
Westford, MA 01886-3629

Mailing address

2 Applewood Dr
Westford, MA 01886-3629
Phone (978) 857-6472

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
107613-SW-LICSWMAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1536710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536710400000",
    "number": "1639652001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 APPLEWOOD DR",
            "city": "WESTFORD",
            "state": "MA",
            "postal_code": "018863629",
            "telephone_number": "978-857-6472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 APPLEWOOD DR",
            "city": "WESTFORD",
            "state": "MA",
            "postal_code": "018863629",
            "telephone_number": "978-857-6472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODBURN-BLOCKER",
        "first_name": "SANDRA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-12",
        "last_updated": "2018-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "107613-SW-LICSW",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2018; 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.