Active NPI
Nicole Waites
- Clinical Social Worker
- Brookline, MA
National Provider Identifier
1871245472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 226729
- Practice address
- 99 Pond Ave Apt 507
Brookline, MA 02445-7117 - Phone
- (857) 225-8816
- NPI assigned
- Jan 25, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 226729 | MA | Primary |
Addresses
Primary practice location
99 Pond Ave Apt 507
Brookline, MA 02445-7117
Mailing address
99 Pond Ave Apt 507
Brookline, MA 02445-7117
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 226729 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724976000000",
"number": "1871245472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "99 POND AVE APT 507",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024457117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "99 POND AVE APT 507",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024457117",
"telephone_number": "857-225-8816"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAITES",
"first_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-25",
"last_updated": "2024-08-30",
"certification_date": "2024-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "226729",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookline, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.