Kristin Blake-Rosenberg, L.I.C.S.W.
Individual provider Active NPI Clinical Social Worker · Westwood, MA
NPI 1801035571 · NPPES record last updated Feb 19, 2009
Key facts
- NPI
- 1801035571
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 1028768 (MA)
- Practice address
- 18 Blue Jay Rd
Westwood, MA 02090-1161 - Phone
- (781) 329-6942
- NPI assigned
- Feb 19, 2009
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1028768 | MA | MD | Clinical Social Worker |
| R061121-1 | NY | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 1028768 | MA | Yes |
| Clinical Social Worker | 1041C0700X | R061121-1 | NY |
Addresses
Primary practice location
18 Blue Jay Rd
Westwood, MA 02090-1161
Mailing address
73 Bourne St
Jamaica Plain, MA 02130-4622
Phone (781) 329-6942
Other providers in Westwood, MA
- Lynn H Bichajian
- Holly Bidlack
- Clifford Bierman
- Bio-Medical Applications of Massachusetts, Inc.
- Magdy M Bishay
- Alan B Blinn
- Matthew Bloch
- Michele Block
- Kelsey Boarman
- Robert Bode
All providers in Westwood, MA · Clinical Social Worker in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.