Individual provider Active NPI

Bonnie M. Roessner, LICSW

  • Clinical Social Worker
  • Westford, MA
National Provider Identifier
1770673105
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
111821 Issued in MA
Practice address
288 Littleton Rd.
Suite 32
Westford, MA 01886
Phone
(617) 312-3346
NPI assigned
Oct 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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 111821 MA Primary

Addresses

Primary practice location

288 Littleton Rd.
Suite 32
Westford, MA 01886

Mailing address

10 Williams St Apt 38
Watertown, MA 02472-4609
Phone (617) 312-3346

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
I20061205000498 MA Practitioner - Clinical Social Worker 5890794622 Practice locations: Acton, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Acton, MA 01720
Phone (617) 312-3346

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
111821MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1160784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1770673105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 WILLIAMS ST APT 38",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024724609",
            "telephone_number": "617-312-3346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "288 LITTLETON RD.",
            "address_2": "SUITE 32",
            "city": "WESTFORD",
            "state": "MA",
            "postal_code": "01886",
            "telephone_number": "617-312-3346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROESSNER",
        "first_name": "BONNIE",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-14",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "111821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westford, MA

Sources for this page

Verify at the official NPI Registry.