Active NPI
Judith M Tully, LICSW
- Clinical Social Worker
- Westboro, MA
National Provider Identifier
1962467787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 106057
- Practice address
- 154 E Main St
Westboro, MA 01581 - Phone
- (508) 870-0647
- Fax
- (508) 799-6325
- NPI assigned
- Apr 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 | 106057 | MA | Primary |
Addresses
Primary practice location
154 E Main St
Westboro, MA 01581
Mailing address
1330 Beacon St
Ste 205
Brookline, MA 02446
Phone (617) 730-5356
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
| License | State | Type | Specialty |
|---|---|---|---|
| 106057 | MA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jonathan Rothman, M.D. | Clinical | Past | Accepting new patients |
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": "1145318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962467787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1330 BEACON ST",
"address_2": "STE 205",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "02446",
"telephone_number": "617-730-5356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "154 E MAIN ST",
"city": "WESTBORO",
"state": "MA",
"postal_code": "01581",
"telephone_number": "508-870-0647",
"fax_number": "508-799-6325"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TULLY",
"first_name": "JUDITH",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "106057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Westboro, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.