Individual provider Active NPI

Rachael E Hennessey-Crowell, LICSW

  • Clinical Social Worker
  • Brookline, MA
National Provider Identifier
1760791313
Registry record updated Jul 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
121068 Issued in MA
Practice address
41 Garrison Rd
Brookline, MA 02445
Phone
(617) 277-8107
Fax
(617) 734-6385
NPI assigned
Sep 30, 2010
Last updated
Jul 13, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 121068 MA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

41 Garrison Rd
Brookline, MA 02445

Mailing address

3 Kenney St Apt 1
Boston, MA 02130-1199
Phone (857) 770-1543

Other practice location 1

5 Lothian Rd
Apartment 1
Brighton, MA 02135-5413
Phone (508) 353-3075

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
I20180823000635 MA Practitioner - Clinical Social Worker 6305195413 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brookline Community Mental Health Center IncGroup PAC ID 9032181433, 27 clinicians

Practice addresses (Care Compare)

43 Garrison Rd
Brookline, MA 02445-4445
Phone 61727781072240

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
121068MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brookline Community Mental Health Center Inc. CurrentSince Jul 10, 2018 Accepting new patients

Locations

41 Garrison Rd
Brookline, MA 02445
Phone (617) 277-8107

43 Garrison Rd
Brookline, MA 02445
Phone (617) 277-8107

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1285804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531440000000",
    "number": "1760791313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 KENNEY ST APT 1",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021301199",
            "telephone_number": "857-770-1543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 GARRISON RD",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "02445",
            "telephone_number": "617-277-8107",
            "fax_number": "617-734-6385"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 Lothian Rd",
            "address_2": "Apartment 1",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MA",
            "postal_code": "021355413",
            "country_code": "US",
            "telephone_number": "508-353-3075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENNESSEY-CROWELL",
        "first_name": "RACHAEL",
        "middle_name": "E",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-30",
        "last_updated": "2018-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "121068",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

Verify at the official NPI Registry.