Active NPI
Jean Richard Desir
- Clinical Social Worker
- Worcester, MA
National Provider Identifier
1689987257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 51 Union St
Worcester, MA 01608-1194 - Phone
- (508) 756-5400
- NPI assigned
- Jul 23, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CT | Primary |
Addresses
Primary practice location
51 Union St
Worcester, MA 01608-1194
Mailing address
3222 Arbor Dr
Shrewsbury, MA 01545-6010
Phone (774) 275-9115
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 95273201 | Other | MA | NETWORK |
| 1487863494 | Other | MA | MMIS |
| 1894196 | Other | MA | MBHP |
| 1081860 | Other | MA | FALLON/BEACON |
| 1894196 | Medicaid | MA |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1279843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1279843200000",
"number": "1689987257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3222 ARBOR DR",
"city": "SHREWSBURY",
"state": "MA",
"postal_code": "015456010",
"telephone_number": "774-275-9115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "51 UNION ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016081194",
"telephone_number": "508-756-5400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESIR",
"first_name": "JEAN",
"middle_name": "RICHARD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-07-23",
"last_updated": "2010-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NETWORK",
"identifier": "95273201",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MMIS",
"identifier": "1487863494",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MBHP",
"identifier": "1894196",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FALLON/BEACON",
"identifier": "1081860",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1894196",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.