Individual provider Active NPI

Kiara Rossborough, LICSW

  • Clinical Social Worker
  • Needham, MA
National Provider Identifier
1972095123
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LICSW126190 Issued in MA
Practice address
175 Highland Ave Ste 308
Needham, MA 02494-3034
Phone
(781) 551-0999
NPI assigned
Jun 4, 2018
Sex
Female
Sole proprietor
No

Organizations & group practices 16

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.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Commonwealth of Massachusetts 141 clinicians

Practice addresses (Care Compare)

165 Quincy St
Brockton, MA 02302-2988
Phone (508) 897-2000

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.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20231129000761 MA Practitioner - Clinical Social Worker 8527416726 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LICSW126190MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Commonwealth of Massachusetts CurrentSince Nov 14, 2024 Accepting new patients
The Commonwealth of Massachusetts CurrentSince Nov 14, 2024 Accepting new patients

Locations

165 Quincy St
Brockton, MA 02302
Phone (508) 897-2000

40 Industrial Park Rd
Plymouth, MA 02360
Phone (508) 732-3000

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LICSW126190 MA Primary

Addresses

NPPES NPI Registry

Primary practice location

175 Highland Ave Ste 308
Needham, MA 02494-3034

Mailing address

21 College Pond Rd
Plymouth, MA 02360-3104

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 22, 2023.

{
    "created_epoch": "1528070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1972095123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 COLLEGE POND RD",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023603104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 HIGHLAND AVE STE 308",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024943034",
            "telephone_number": "781-551-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSSBOROUGH",
        "first_name": "KIARA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-04",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "LICSW126190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Needham, MA

Sources for this page

Verify at the official NPI Registry.