Organization Active NPI

Kaibigan Therapy

  • Clinical Social Worker
  • Needham, MA
National Provider Identifier
1780423228
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
KAIBIGAN THERAPY
Practice address
24 Maple St
Needham, MA 02492-2342
Phone
(617) 320-5450
NPI assigned
May 23, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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

Authorized official

Name
Bethany Bonner, LICSWNPI 1770076812
Title
Owner
Phone
(617) 320-5450

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

24 Maple St
Needham, MA 02492-2342

Mailing address

24 Maple St
Needham, MA 02492-2342
Phone (617) 320-5450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241113004213 MA Part B Supplier - Clinic/Group Practice 2567996572 Receives reassigned benefits from 1 practitioner
Practice locations: Needham, MA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1716422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734912000000",
    "number": "1780423228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 MAPLE ST",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024922342",
            "telephone_number": "617-320-5450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 MAPLE ST",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024922342",
            "telephone_number": "617-320-5450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAIBIGAN THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-23",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A",
        "authorized_official_last_name": "BONNER",
        "authorized_official_first_name": "BETHANY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-320-5450",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Needham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.