Individual provider Active NPI

Kirsten E Grace, LICSW

  • Clinical Social Worker
  • Foxboro, MA
National Provider Identifier
1700822277
Registry record updated Apr 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1031721 Issued in MA
Practice address
34 School St Ste 207
Foxboro, MA 02035-2318
Phone
(508) 505-7403
Fax
(508) 608-1051
NPI assigned
Jun 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2011

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 1031721 MA Primary

Addresses

Primary practice location

34 School St Ste 207
Foxboro, MA 02035-2318

Mailing address

34 School St Ste 207
Foxboro, MA 02035-2318
Phone (508) 505-7403

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20060807000276 MA Practitioner - Clinical Social Worker 1951304294 Practice locations: Foxboro, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

34 School St
Suite 207
Foxboro, MA 02035-2318
Phone (508) 505-7403

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004399CTMDClinical Social Worker
1031721MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Neponset Valley Counseling Center Clinical Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301875200000",
    "number": "1700822277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 SCHOOL ST STE 207",
            "city": "FOXBORO",
            "state": "MA",
            "postal_code": "020352318",
            "telephone_number": "508-505-7403",
            "fax_number": "508-608-1051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 SCHOOL ST STE 207",
            "city": "FOXBORO",
            "state": "MA",
            "postal_code": "020352318",
            "telephone_number": "508-505-7403",
            "fax_number": "508-608-1051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACE",
        "first_name": "KIRSTEN",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2011-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1031721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Foxboro, MA

Sources for this page

Verify at the official NPI Registry.