Individual provider Active NPI

Alexa Diane Kaczmarski, LCSW, MED

  • Clinical Social Worker
  • Boston, MA
National Provider Identifier
1922723063
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LICSW1140225 Issued in MA
Practice address
16 Rossmore Rd Apt 3
Boston, MA 02130-3850
Phone
(609) 760-8651
NPI assigned
Oct 11, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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 LICSW1140225 MA Primary

Addresses

Primary practice location

16 Rossmore Rd Apt 3
Boston, MA 02130-3850

Mailing address

16 Rossmore Rd Apt 3
Boston, MA 02130-3850
Phone (609) 760-8651

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
I20250630003792 MA Practitioner - Clinical Social Worker 8820501117 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Education

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Family Psychological Services, PLLC Clinical CurrentSince May 27, 2025 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

175 Highland Ave
Ste 308
Needham, MA 02494
Phone (781) 474-5280

89 Access Rd
Ste 24
Norwood, MA 02062
Phone (781) 336-5040

Organizations & group practices 1

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": "1665446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1922723063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 ROSSMORE RD APT 3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021303850",
            "telephone_number": "609-760-8651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 ROSSMORE RD APT 3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021303850",
            "telephone_number": "609-760-8651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KACZMARSKI",
        "first_name": "ALEXA",
        "middle_name": "DIANE",
        "credential": "LCSW, MED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-11",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "LICSW1140225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.