John James Deronck in Brookline - Clinical
John James Deronck - NPI 1508914631
John James Deronck is a Clinical in Brookline, Massachusetts. John James Deronck practices all healthcare services and medical treatments related to Clinical. The NPI Number for John James Deronck is 1508914631. The last update date is 2007-07-08.
John James Deronck's current location address is 12 Kerrigan Pl, Brookline, Massachusetts. You can contact this provider via phone number 6177317864. The mailing address for John James Deronck is 12 Kerrigan Pl, Brookline, Massachusetts. To know further, please read the information below!
Provider Profile Detail
| Provider Name | John James Deronck |
|---|---|
| Address | 12 Kerrigan Pl, Brookline, Massachusetts |
| Phone Number | 6177317864 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | LICSW |
NPI Number Detail
| NPI Number | 1508914631 |
|---|---|
| Provider Enumeration Date | 2007-01-08 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 12 Kerrigan Pl |
|---|---|
| City | Brookline |
| State | Massachusetts (MA) |
| Post Code | 24457626 |
| Phone Number | 6177317864 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 113897 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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What is the unique identifier code issued to John James Deronck by the Centers for Medicare & Medicaid Services?
The John James Deronck has been assigned the NPI (National Provider Identifier) 1508914631. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of John James Deronck?
The John James Deronck is situated at 12 Kerrigan Pl, in the city of Brookline, state of MA, with the zip code 24457626.
What is the John James Deronck's area of specialization and corresponding taxonomy classification?
The John James Deronck's specialty field is Clinical, and it falls under the taxonomy code 1041C0700X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services assign the 1508914631 to John James Deronck?
The Centers for Medicare & Medicaid Services assigned the 1508914631 to John James Deronck on 2007-01-08.
As of what date were the details pertaining to John James Deronck last refreshed?
The information related to the John James Deronck, including its address, specialty, and other relevant details, was last updated on 2007-07-08.
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