Rebecca Jean Faherty, LICSW, LADC1, C-SWHC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

114617 Issued in MA

Practice address

940 Belmont Street
Brockton, MA 02601

Phone

(508) 583-4500

Fax

(774) 826-2073

NPI assigned

Oct 3, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Third Space Therapy PLLC

  • Mental Health Counselor
  • Houston, TX
  • NPI 1215780234

  MA

  Medicare reassignment NPD
• Boston Vamc

  • Department of Veterans Affairs (VA) Pharmacy
  • Boston, MA
  • NPI 1215995410
  NPD (past)
• New York State Health Medical PC

  • Mental Health Counselor
  • New York, NY
  • NPI 1043156029
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292284800000",
    "number": "1699860148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 BELMONT STREET",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "02601",
            "telephone_number": "508-583-4500",
            "fax_number": "774-826-2073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 BELMONT STREET",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "02601",
            "telephone_number": "508-583-4500",
            "fax_number": "774-826-2073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAHERTY",
        "first_name": "REBECCA",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "LICSW, LADC1, C-SWHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2010-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "1100",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "114617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ilene Ellen Fabisch, IBCLC
• Raquel Fabroski
• Cheryl Lyn Factor, MS CHILD FAMILY COUN
• Jena Faeorest, PA-C
• Jared Michael Fagerstrom, DPT
• Ian Robert Fair, PA-C
• Toni Fairhurst
• Amelia Falavinha, RN, MSN
• Thalia Falcon, MSW, LCSW
• Kensie Faldoski

• Clinical Social Worker in Brockton, MA
• Providers in Brockton, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.