Individual provider Active NPI

Monique N Tucker-Rhudd, MSW

  • Clinical Social Worker
  • Jamaica Plain, MA
National Provider Identifier
1821246455
Registry record updated Sep 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
118466 Issued in MA
Practice address
31 Heath St
Jamaica Plain, MA 02130-1650
Phone
(617) 523-6400
Fax
(617) 523-3034
NPI assigned
Sep 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X 118466 MA Primary

Addresses

Primary practice location

31 Heath St
Jamaica Plain, MA 02130-1650

Mailing address

31 Heath St
Jamaica Plain, MA 02130-1650
Phone (617) 523-6400

Other identifiers 1

IdentifierTypeStateIssuer
1303414MedicaidMA

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
I20190320001783 MA Practitioner - Clinical Social Worker 4385801521 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
118466MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Randolph Behavioral Health Services, Inc. Mental Health CurrentSince Mar 4, 2019 Accepting new patients
Randolph Behavioral Health Services, Inc. Mental Health CurrentSince Mar 4, 2019 Accepting new patients
Family Service Association of Greater Boston Past Accepting new patients

Locations

21 Mazzeo Dr
Ste 102
Randolph, MA 02368
Phone (781) 437-7507

4 Frank Leary Way
#4
Randolph, MA 02368
Phone (781) 885-7530

4 Frank Leary Way
Ste D
Randolph, MA 02368
Phone (781) 885-7530

Organizations & group practices 3

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": "1220832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600646400000",
    "number": "1821246455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 HEATH ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021301650",
            "telephone_number": "617-523-6400",
            "fax_number": "617-523-3034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 HEATH ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021301650",
            "telephone_number": "617-523-6400",
            "fax_number": "617-523-3034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER-RHUDD",
        "first_name": "MONIQUE",
        "middle_name": "N",
        "name_prefix": "Mrs.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-08",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "118466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1303414",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica Plain, MA

Sources for this page

Verify at the official NPI Registry.