Haven Fyfe-Kiernan, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

114084 Issued in MA

Practice address

1101 Beacon St
Brookline, MA 02446-5587

Phone

(617) 739-1022

NPI assigned

Oct 18, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• The Wellness Room

  • Community/Behavioral Health Agency
  • Newton, MA
  • NPI 1841554300
  NPD (past) Authorized official

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

{
    "created_epoch": "1192665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192665600000",
    "number": "1881883544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 COLUMBUS ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024611436",
            "telephone_number": "617-775-5373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 BEACON ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024465587",
            "telephone_number": "617-739-1022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FYFE-KIERNAN",
        "first_name": "HAVEN",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-18",
        "last_updated": "2007-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "114084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Fuentes, CCC-SLP
• Dana Kailani Fugelso, M.D.
• Isaac Fuhrman, LICSW
• Amanda Kathryn Fuller, MHC
• Future Smiles of America
• Gabriel Boustani DMD PC
• Laurel Whitney Gaffin, MD
• Stephanie Gaglini, CCC-SLP
• Shaun Gaipo, MAOM
• Calliope J Galatis, OD

• Clinical Social Worker in Brookline, MA
• Providers in Brookline, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.