Active NPI
Susan Kazolias, LCSW
- Clinical Social Worker
- Brockton, MA
National Provider Identifier
1952464406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 213535
- Practice address
- 37 Belmont St
Brockton, MA 02301 - Phone
- (508) 580-4691
- Fax
- (508) 588-5751
- NPI assigned
- Dec 18, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 213535 | MA | Primary |
Addresses
Primary practice location
37 Belmont St
Brockton, MA 02301
Mailing address
153 O Street
South Boston, MA 02127
Phone (845) 489-4789
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080619000134 | MA | Practitioner - Clinical Social Worker | 0648341651 | Practice locations: Hingham, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
175 Derby St
Suite 20
Hingham, MA 02043-4051
Phone (845) 489-4789
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 213535 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1952464406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "153 O STREET",
"city": "SOUTH BOSTON",
"state": "MA",
"postal_code": "02127",
"telephone_number": "845-489-4789"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "37 BELMONT ST",
"city": "BROCKTON",
"state": "MA",
"postal_code": "02301",
"telephone_number": "508-580-4691",
"fax_number": "508-588-5751"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAZOLIAS",
"first_name": "SUSAN",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "213535",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brockton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.