Individual provider Active NPI

Rachel Joy Stouck, LCSW

  • Clinical Social Worker
  • Braintree, MA
National Provider Identifier
1851905210
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
000225098 Issued in MA
Practice address
222 Forbes Rd Ste 207
Braintree, MA 02184-2720
Phone
(781) 298-7934
NPI assigned
Sep 3, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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 000225098 MA Primary

Addresses

Primary practice location

222 Forbes Rd Ste 207
Braintree, MA 02184-2720

Mailing address

14 Dodge St
Cambridge, MA 02139-2904
Phone (301) 802-2414

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
I20220527001929 MA Practitioner - Clinical Social Worker 1456739705

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000225098MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Equilibria Mental Health LLC CurrentSince Mar 20, 2022 Accepting new patients
Stouckwellness CurrentSince Oct 23, 2022 Accepting new patients

Locations

222 Forbes Rd
Ste 207
Braintree, MA 02184
Phone (781) 298-7196

960 Turnpike St
Ste 11B
Canton, MA 02021
Phone (508) 614-8307

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": "1599091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1851905210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 DODGE ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021392904",
            "telephone_number": "301-802-2414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 FORBES RD STE 207",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021842720",
            "telephone_number": "781-298-7934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUCK",
        "first_name": "RACHEL",
        "middle_name": "JOY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-03",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "000225098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Braintree, MA

Sources for this page

Verify at the official NPI Registry.