Kerline Theodore

Primary specialty

Social WorkerTaxonomy code 104100000X

License

219613 Issued in MA

Practice address

1082 Davol St
Fall River, MA 02720-1124

Phone

(617) 756-2986

NPI assigned

Jan 8, 2018

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 8, 2018.

{
    "created_epoch": "1515369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515369600000",
    "number": "1972010304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2954",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027222954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1082 DAVOL ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027201124",
            "telephone_number": "617-756-2986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEODORE",
        "first_name": "KERLINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-08",
        "last_updated": "2018-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "219613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Commonwealth of Massachusetts
• The Commonwealth of Massachusetts
• The Grove at Carvalho LLC
• The Stop & Shop Supermarket Company, LLC
• The Stop & Shop Supermarket Company, LLC
• Mark Francis Theodore, MA, LSW
• Therapy Resources Management, LLC
• Deana Marie Theroux, MD
• Marc A Theroux, MD
• Angela Jean Therrien, LMHC, LADC1

• All providers in Fall River, MA
• Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.