Individual provider Active NPI

Angela Nash Hennemuth, LICSW

  • Clinical Social Worker
  • Brewster, MA
National Provider Identifier
1902031495
Registry record updated Oct 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
111887 Issued in MA
Practice address
227 Run Hill Rd
Brewster, MA 02631-2331
Phone
(774) 212-2550
NPI assigned
May 27, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2009

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 111887 MA Primary

Addresses

Primary practice location

227 Run Hill Rd
Brewster, MA 02631-2331

Mailing address

227 Run Hill Rd
Brewster, MA 02631-2331
Phone (774) 212-2550

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

LicenseStateTypeSpecialty
111887MAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1243382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255910400000",
    "number": "1902031495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 RUN HILL RD",
            "city": "BREWSTER",
            "state": "MA",
            "postal_code": "026312331",
            "telephone_number": "774-212-2550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 RUN HILL RD",
            "city": "BREWSTER",
            "state": "MA",
            "postal_code": "026312331",
            "telephone_number": "774-212-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASH HENNEMUTH",
        "first_name": "ANGELA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-27",
        "last_updated": "2009-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "111887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brewster, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2009; 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.