Individual provider Active NPI

Natasha Kovalchuk

  • Clinical Social Worker
  • Newton, MA
National Provider Identifier
1760539977
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1022479 Issued in MA
Practice address
93 Union St # SW.406
Newton, MA 02459-2244
Phone
(617) 965-4654
Fax
(617) 527-4639
NPI assigned
Jan 3, 2007
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 1022479 MA Primary

Addresses

Primary practice location

93 Union St # SW.406
Newton, MA 02459-2244

Mailing address

76 Boylston St Apt 3
Chestnut Hill, MA 02467-2220
Phone (617) 921-6621

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
I20051014000483 MA Practitioner - Clinical Social Worker 8527084920 Practice locations: Sharon, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

168 Ames St
Sharon, MA 02067-2217
Phone (617) 965-4654

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1022479MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760539977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 BOYLSTON ST APT 3",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024672220",
            "telephone_number": "617-921-6621",
            "fax_number": "617-527-4639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 UNION ST # SW.406",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024592244",
            "telephone_number": "617-965-4654",
            "fax_number": "617-527-4639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVALCHUK",
        "first_name": "NATASHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1022479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, MA

Sources for this page

Verify at the official NPI Registry.