Simone Tetrault, L.I.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

111545 Issued in MA

Practice address

448 Marshall St
Holliston, MA 01746-1440

Phone

(617) 610-0137

NPI assigned

Jan 22, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536192000000",
    "number": "1790839207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "448 MARSHALL ST",
            "city": "HOLLISTON",
            "state": "MA",
            "postal_code": "017461440",
            "telephone_number": "617-610-0137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "448 MARSHALL ST",
            "city": "HOLLISTON",
            "state": "MA",
            "postal_code": "017461440",
            "telephone_number": "617-610-0137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TETRAULT",
        "first_name": "SIMONE",
        "name_prefix": "Ms.",
        "credential": "L.I.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2018-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "111545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven E Katz D.C., P.a.
• Dennis John Sweeney, M.A.LMHC
• Audrea Szabatura, PHARMD
• Julius Tanyi V Tabe, M.D
• Roseline Kong Tabe, RN,BSN
• Rachael Thalheimer, MSW, LCSW
• Through the Valley Counseling
• Mark Tlumacki, O.P.
• Bretton Patton Torkelson, PSY.D.
• Town of Holliston

• Clinical Social Worker in Holliston, MA
• Providers in Holliston, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2018; 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.