Individual provider Active NPI

Dorothy L Koerner, L.I.C.S.W., MSW

  • Clinical Social Worker
  • Boston, MA
National Provider Identifier
1790859049
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
103588 Issued in MA
Practice address
41 Concord SQ
Boston, MA 02118-3101
Phone
(617) 738-7668
Fax
(617) 353-1761
NPI assigned
Nov 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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 103588 MA Primary

Addresses

Primary practice location

41 Concord SQ
Boston, MA 02118-3101

Mailing address

41 Concord SQ
Boston, MA 02118-3101
Phone (617) 738-7668

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
I20050518000872 MA Practitioner - Clinical Social Worker 7911948146 Practice locations: Boston, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

41 Concord SQ
Boston, MA 02118-3101
Phone (617) 738-7668

41 Concord Square
Boston, MA 02118-3101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790859049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 CONCORD SQ",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021183101",
            "telephone_number": "617-738-7668",
            "fax_number": "617-353-1761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 CONCORD SQ",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021183101",
            "telephone_number": "617-738-7668",
            "fax_number": "617-353-1761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOERNER",
        "first_name": "DOROTHY",
        "middle_name": "L",
        "credential": "L.I.C.S.W., MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "103588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.