Individual provider Active NPI

Susan Hazel Gere, MSW, PH.D.

  • Clinical Social Worker
  • Cambridge, MA
National Provider Identifier
1821139916
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
100095 Issued in MA
Practice address
875 Massachusetts Ave Ste 24
Cambridge, MA 02139-3070
Phone
(617) 547-8135
Fax
(617) 547-8135
NPI assigned
Feb 9, 2007
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 100095 MA Primary

Addresses

Primary practice location

875 Massachusetts Ave Ste 24
Cambridge, MA 02139-3070

Mailing address

875 Massachusetts Ave Ste 24
Cambridge, MA 02139-3070
Phone (617) 547-8135

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
100095MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821139916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 MASSACHUSETTS AVE STE 24",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021393070",
            "telephone_number": "617-547-8135",
            "fax_number": "617-547-8135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 MASSACHUSETTS AVE STE 24",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021393070",
            "telephone_number": "617-547-8135",
            "fax_number": "617-547-8135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERE",
        "first_name": "SUSAN",
        "middle_name": "HAZEL",
        "name_prefix": "Dr.",
        "credential": "MSW, PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "100095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.