Individual provider Active NPI

Julie A Canfield, LICSW, PHD

  • Clinical Social Worker
  • Brookline, MA
National Provider Identifier
1770640260
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1025118 Issued in MA
Practice address
1170 Beacon St
Brookline, MA 02446-3963
Phone
(617) 816-9469
Fax
(617) 553-0933
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 1025118 MA Primary

Addresses

Primary practice location

1170 Beacon St
Brookline, MA 02446-3963

Mailing address

4 Cornauba Street Ext
Roslindale, MA 02131-3629
Phone (617) 816-9469

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)
Enrolled
Credentials
Doctor of Philosophy

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": "1770640260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 CORNAUBA STREET EXT",
            "city": "ROSLINDALE",
            "state": "MA",
            "postal_code": "021313629",
            "telephone_number": "617-816-9469",
            "fax_number": "617-553-0933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 BEACON ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024463963",
            "telephone_number": "617-816-9469",
            "fax_number": "617-553-0933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANFIELD",
        "first_name": "JULIE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "LICSW, PHD",
        "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": "1025118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.