Individual provider Active NPI

Rebekah Iaccarino, LICSW

  • Social Worker
  • Waltham, MA
National Provider Identifier
1982373650
Registry record updated Oct 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LICSW1141240 Issued in MA
Practice address
431 River St Ste 1
Waltham, MA 02453-5483
Phone
(781) 891-0555
NPI assigned
Sep 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LICSW1141240 MA Primary

Addresses

Primary practice location

431 River St Ste 1
Waltham, MA 02453-5483

Mailing address

431 River St Ste 1
Waltham, MA 02453-5483
Phone (781) 891-0555

Other practice location 1

5 High St Ste 101
Medford, MA 02155-3800
Phone (781) 338-2640

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

LicenseStateTypeSpecialty
LICSW1141240MAMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1630972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760659200000",
    "number": "1982373650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 RIVER ST STE 1",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024535483",
            "telephone_number": "781-891-0555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 RIVER ST STE 1",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024535483",
            "telephone_number": "781-891-0555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 High St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "MA",
            "postal_code": "021553800",
            "country_code": "US",
            "telephone_number": "781-338-2640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IACCARINO",
        "first_name": "REBEKAH",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-07",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "LICSW1141240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2025; 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.