Individual provider Active NPI

Hugo William Wiberg III, LCSW

  • Social Worker
  • North Reading, MA
National Provider Identifier
1770930596
Registry record updated May 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
336715 Issued in MA
Practice address
17 Woodland Dr
North Reading, MA 01864-2518
Phone
(978) 664-4447
NPI assigned
May 22, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 336715 MA Primary

Addresses

Primary practice location

17 Woodland Dr
North Reading, MA 01864-2518

Mailing address

17 Woodland Dr
North Reading, MA 01864-2518
Phone (978) 664-4447

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

LicenseStateTypeSpecialty
336715MAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1463875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463875200000",
    "number": "1770930596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 WOODLAND DR",
            "city": "NORTH READING",
            "state": "MA",
            "postal_code": "018642518",
            "telephone_number": "978-664-4447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 WOODLAND DR",
            "city": "NORTH READING",
            "state": "MA",
            "postal_code": "018642518",
            "telephone_number": "978-664-4447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIBERG",
        "first_name": "HUGO",
        "middle_name": "WILLIAM",
        "name_suffix": "III",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-22",
        "last_updated": "2016-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "336715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Reading, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2016; 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.