Individual provider Active NPI

Joan W. Berlin, LICSW

  • Social Worker
  • West Newton, MA
National Provider Identifier
1912958943
Registry record updated Jun 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
102243 Issued in MA
Practice address
1121 Washington St
Ste 4
West Newton, MA 02465-2150
Phone
(617) 620-9202
NPI assigned
May 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 102243 MA Primary

Addresses

Primary practice location

1121 Washington St
Ste 4
West Newton, MA 02465-2150

Mailing address

1121 Washington St
Ste 4
West Newton, MA 02465-2150
Phone (617) 620-9202

Other identifiers 3

IdentifierTypeStateIssuer
669490OtherMATUFTS HEALTH PLAN
0014260OtherMANEIGHBORHOOD HEALTH PLAN
P02067OtherMABLUE CROSS

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
I20050923000511 MA Practitioner - Clinical Social Worker 4880628361 Practice locations: West Newton, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1121 Washington St
Suite 4
West Newton, MA 02465-2150
Phone (617) 969-2500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
102243MAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1912958943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 WASHINGTON ST",
            "address_2": "STE 4",
            "city": "WEST NEWTON",
            "state": "MA",
            "postal_code": "024652150",
            "telephone_number": "617-620-9202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 WASHINGTON ST",
            "address_2": "STE 4",
            "city": "WEST NEWTON",
            "state": "MA",
            "postal_code": "024652150",
            "telephone_number": "617-620-9202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERLIN",
        "first_name": "JOAN",
        "middle_name": "W.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-15",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "102243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "669490",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "0014260",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "P02067",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Newton, MA

Sources for this page

Verify at the official NPI Registry.