NPIMap

Organization Active NPI

Jill S Engerman Psychotherapy Associates, LLC

  • Clinical Social Worker
  • Waltham, MA
National Provider Identifier
1992139356
Registry record updated Aug 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LICSW114424 Issued in MA
Legal business name
JILL S ENGERMAN PSYCHOTHERAPY ASSOCIATES, LLC
Practice address
40 Crescent Street
Suite 205
Waltham, MA 02543
Phone
(978) 505-2779
NPI assigned
Aug 21, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2013

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

Authorized official

Name
Mrs. Jill Steele Engerman, LICSW
Title
Owner
Phone
(978) 505-2779

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X LICSW114424 MA Primary

Addresses

Primary practice location

40 Crescent Street
Suite 205
Waltham, MA 02543

Mailing address

40 Crescent Street
Suite 205
Waltham, MA 02543
Phone (978) 505-2779

National Provider Directory

National Provider Directory
Tax ID family
Jill S Engerman Psychotherapy Associates LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

40 Crescent St
Ste 205
Waltham, MA 02453
Phone (617) 564-3756

NPI Registry JSON

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

{
    "created_epoch": "1377043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377043200000",
    "number": "1992139356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 CRESCENT STREET",
            "address_2": "SUITE 205",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "02543",
            "telephone_number": "978-505-2779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 CRESCENT STREET",
            "address_2": "SUITE 205",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "02543",
            "telephone_number": "978-505-2779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JILL S ENGERMAN PSYCHOTHERAPY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-21",
        "last_updated": "2013-08-21",
        "status": "A",
        "authorized_official_last_name": "ENGERMAN",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "STEELE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "978-505-2779",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "LICSW114424",
            "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 Aug 21, 2013; 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.