KELLY FOURNIER (LICSW) – Clinical Social Worker, NPI 1750379780
Clinical Social Worker
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,194 CLINICAL SOCIAL WORKER in MA
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Provider Addresses for KELLY FOURNIER (LICSW)
Doctors Office Building, 720, Harrison Avenue, South End, Boston, Suffolk County, Massachusetts, 02118, United States
DOB 503
BOSTON, MA 02118
Phone:
Type: Mailing
Preston Family Building, 732, Harrison Avenue, South End, Boston, Suffolk County, Massachusetts, 02118, United States
PRESTON FAMILY BUILDING 2ND FLOOR
BOSTON, MA 021182309
Phone: (617) 638-6843
Fax: (617) 638-7449
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2015-03-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20150317001626 | I | Clinical Social Worker | MA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 90832 | Psychotherapy, 30 minutes | 32 | 13 | $0 |
| 90791 | Psychiatric diagnostic evaluation | 21 | 21 | $0 |
Insurance plans in this area (ZIP 02118)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Psychologist | MA | |
| - | MA | |
| Clinical Psychologist | MA | |
| - | MA | |
| Clinical Psychologist | MA | |
| - | TX | |
| - | MA | |
| Clinical Social Worker | MA | |
| P S Y C H I A T R Y | ME | |
| - | MA |
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