Individual provider Active NPI

Debra Marie Kott, LICSW

  • Clinical Social Worker
  • Orange, MA
National Provider Identifier
1831103233
Registry record updated Aug 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
110778 Issued in MA
Practice address
131 W Main St
Orange, MA 01364
Phone
(978) 544-2148
NPI assigned
Jul 28, 2006
Last updated
Aug 1, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2018

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 110778 MA Primary

Addresses

Primary practice location

131 W Main St
Orange, MA 01364

Mailing address

113 New Athol Rd Unit 40
Orange, MA 01364-9666
Phone (508) 341-5614

Other practice location 1

205 School St
Gardner, MA 01440-2781
Phone (978) 632-2321 ext. 19

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
I20051022000076 MA Practitioner - Clinical Social Worker 7214953884 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
110778MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Child & Family Services, Inc. CurrentSince Nov 12, 2018 Accepting new patients
Youth Opportunities Upheld, Inc. Past Accepting new patients

Locations

3057 Acushnet Ave
New Bedford, MA 02745
Phone (508) 742-1040

965 Church St
New Bedford, MA 02745
Phone (508) 996-3154

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/youinc/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533081600000",
    "number": "1831103233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 NEW ATHOL RD UNIT 40",
            "city": "ORANGE",
            "state": "MA",
            "postal_code": "013649666",
            "telephone_number": "508-341-5614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 W MAIN ST",
            "city": "ORANGE",
            "state": "MA",
            "postal_code": "01364",
            "telephone_number": "978-544-2148"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 School St",
            "address_purpose": "LOCATION",
            "city": "Gardner",
            "state": "MA",
            "postal_code": "014402781",
            "country_code": "US",
            "telephone_number": "978-632-2321 x19",
            "fax_number": "978-630-3049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOTT",
        "first_name": "DEBRA",
        "middle_name": "MARIE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2018-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "110778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, MA

Sources for this page

Verify at the official NPI Registry.