Active NPI
Deborah Forman
- Social Worker
- Belmont, MA
National Provider Identifier
1730661554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 113849
- Practice address
- 22 Temple St
Belmont, MA 02478-3545 - Phone
- (617) 489-4805
- NPI assigned
- Aug 29, 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 113849 | MA | Primary |
Addresses
Primary practice location
22 Temple St
Belmont, MA 02478-3545
Mailing address
22 Temple St
Belmont, MA 02478-3545
Phone (617) 489-4805
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 113849 | MA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535500800000",
"number": "1730661554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 TEMPLE ST",
"city": "BELMONT",
"state": "MA",
"postal_code": "024783545",
"telephone_number": "617-489-4805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 TEMPLE ST",
"city": "BELMONT",
"state": "MA",
"postal_code": "024783545",
"telephone_number": "617-489-4805"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORMAN",
"first_name": "DEBORAH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-08-29",
"last_updated": "2018-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MA",
"license": "113849",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Belmont, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.