Individual provider Active NPI

Devon O'Brien, MSW, LICSW

  • Clinical Social Worker
  • Boston, MA
National Provider Identifier
1932683935
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
124447 Issued in MA
Practice address
64 Williams St Apt 3
Boston, MA 02130
Phone
(176) 334-5059
NPI assigned
Sep 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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 124447 MA Primary

Addresses

Primary practice location

64 Williams St Apt 3
Boston, MA 02130

Mailing address

450 Providence Hwy # 1091
Dedham, MA 02026-6815
Phone (176) 334-5059

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
I20240206002953 MA Practitioner - Clinical Social Worker 3173903564 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
124447MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham & Womens Hospital, Inc. CurrentSince Dec 25, 2023 Accepting new patients

Locations

75 Francis St
Boston, MA 02115

399 Revolution Dr
Somerville, MA 02145
Phone (800) 856-1983

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": "1537142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1932683935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 PROVIDENCE HWY # 1091",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020266815",
            "telephone_number": "176-334-5059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 WILLIAMS ST APT 3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02130",
            "telephone_number": "176-334-5059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "DEVON",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-17",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "124447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.