Individual provider Active NPI

Christine Carol Fitzgerald, LICSW

  • Clinical Social Worker
  • Jamaica Plain, MA
National Provider Identifier
1811034473
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
161 S Huntington Ave
Jamaica Plain, MA 02130-4885
Phone
(617) 264-5362
Fax
(617) 232-7925
NPI assigned
Jan 31, 2007
Sex
Female
Sole proprietor
No

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 Primary

Addresses

Primary practice location

161 S Huntington Ave
Jamaica Plain, MA 02130-4885

Mailing address

70 Centre St
4E
Brookline, MA 02446-2841
Phone (617) 816-5669

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
I20190425002232 MA Practitioner - Clinical Social Worker 7315289279 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Compassionate Counseling CompanyGroup PAC ID 9830474618, 9 clinicians

Practice addresses (Care Compare)

4 Hartwell St
Suite 201
Fall River, MA 02721-3019
Phone (774) 218-5440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Compassionate Counseling Company CurrentSince Aug 1, 2023 Accepting new patients
Brigham & Womens Hospital, Inc. CurrentSince Apr 1, 2018 Accepting new patients

Locations

75 Francis St
Boston, MA 02115

4 Hartwell St
Ste 201
Fall River, MA 02721
Phone (774) 218-5440

399 Revolution Dr
Somerville, MA 02145
Phone (800) 856-1983

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811034473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 CENTRE ST",
            "address_2": "4E",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024462841",
            "telephone_number": "617-816-5669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 S HUNTINGTON AVE",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021304885",
            "telephone_number": "617-264-5362",
            "fax_number": "617-232-7925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "CHRISTINE",
        "middle_name": "CAROL",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica Plain, MA

Sources for this page

Verify at the official NPI Registry.