Active NPI
Meghan Kennedy
- Clinical Social Worker
- Newton, MA
National Provider Identifier
1972087690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 114833
- Practice address
- 62 Newtonville Ave
Newton, MA 02458-1939 - Phone
- (617) 413-2630
- NPI assigned
- Sep 19, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | 114833 | MA | Primary |
Addresses
Primary practice location
62 Newtonville Ave
Newton, MA 02458-1939
Mailing address
62 Newtonville Ave
Newton, MA 02458-1939
Phone (617) 413-2630
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 114833 | Other | MA | SOCIAL WORK LICENSE |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 114833 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537315200000",
"number": "1972087690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "62 NEWTONVILLE AVE",
"city": "NEWTON",
"state": "MA",
"postal_code": "024581939",
"telephone_number": "617-413-2630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "62 NEWTONVILLE AVE",
"city": "NEWTON",
"state": "MA",
"postal_code": "024581939",
"telephone_number": "617-413-2630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "MEGHAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-09-19",
"last_updated": "2018-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "114833",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOCIAL WORK LICENSE",
"identifier": "114833",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.