Individual provider Active NPI

Cynthia C Brown, LICSW

  • Clinical Social Worker
  • Acton, MA
National Provider Identifier
1699823724
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
106278 Issued in MA
Practice address
481 Great Rd
Acton, MA 01720-4157
Phone
(978) 266-1940
Fax
(978) 692-4784
NPI assigned
Jan 8, 2007
Last updated
Jul 8, 2007By the provider in NPPES
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 106278 MA Primary

Addresses

Primary practice location

481 Great Rd
Acton, MA 01720-4157

Mailing address

481 Great Rd
Acton, MA 01720-4157
Phone (978) 266-1940

Other identifiers 1

IdentifierTypeStateIssuer
P04067OtherMABLUE CROSS ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Sep 13, 2021 through Sep 13, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
106278MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699823724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "481 GREAT RD",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "017204157",
            "telephone_number": "978-266-1940",
            "fax_number": "978-692-4784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "481 GREAT RD",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "017204157",
            "telephone_number": "978-266-1940",
            "fax_number": "978-692-4784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "CYNTHIA",
        "middle_name": "C",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "106278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS ID",
            "identifier": "P04067",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Acton, MA

Sources for this page

Verify at the official NPI Registry.