Active NPI
Jennifer Robin Thorell
- Clinical Social Worker
- West Newton, MA
National Provider Identifier
1720563455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 1507 Washington St
West Newton, MA 02465-2219 - Phone
- (617) 965-0764
- NPI assigned
- Sep 28, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | Primary |
Addresses
Primary practice location
1507 Washington St
West Newton, MA 02465-2219
Mailing address
25 Daniel Dr
Bellingham, MA 02019-1923
Phone (781) 710-3873
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110901 | Other | LICSW |
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": "1538092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538092800000",
"number": "1720563455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 DANIEL DR",
"city": "BELLINGHAM",
"state": "MA",
"postal_code": "020191923",
"telephone_number": "781-710-3873"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1507 WASHINGTON ST",
"city": "WEST NEWTON",
"state": "MA",
"postal_code": "024652219",
"telephone_number": "617-965-0764"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THORELL",
"first_name": "JENNIFER",
"middle_name": "ROBIN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-09-28",
"last_updated": "2018-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICSW",
"identifier": "110901",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in West Newton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.