Individual provider Active NPI

Richard L Phillipps, LICSW

  • Clinical Social Worker
  • Newton, MA
National Provider Identifier
1982731808
Registry record updated Feb 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1017162 Issued in MA
Practice address
136 Dickerman Rd
Newton, MA 02461-1304
Phone
(617) 332-6524
Fax
(617) 332-1652
NPI assigned
Feb 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1017162 MA Primary

Addresses

Primary practice location

136 Dickerman Rd
Newton, MA 02461-1304

Mailing address

136 Dickerman Rd
Newton, MA 02461-1304
Phone (617) 332-6524

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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160601000415 MA Practitioner - Clinical Social Worker 7719277953 Practice locations: Newton, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1171 Washington St
Newton, MA 02465-2154
Phone (617) 332-6524

136 Dickerman Rd
Newton, MA 02461-1304

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1017162MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391990400000",
    "number": "1982731808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 DICKERMAN RD",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024611304",
            "telephone_number": "617-332-6524",
            "fax_number": "617-332-1652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 DICKERMAN RD",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024611304",
            "telephone_number": "617-332-6524",
            "fax_number": "617-332-1652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPPS",
        "first_name": "RICHARD",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2014-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1017162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, MA

Sources for this page

Verify at the official NPI Registry.