NPIMap

Organization Active NPI

Mary C. Tarvin, MSW, Licsw, P.C.

Doing business as Mary C. Tarvin, LICSW

  • Clinical Social Worker
  • Norwood, MA
National Provider Identifier
1003360603
Registry record updated Aug 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
114647 Issued in MA
Legal business name
MARY C. TARVIN, MSW, LICSW, P.C.
Doing business as
Mary C. Tarvin, LICSW
Practice address
1 Walpole St
Suite 1
Norwood, MA 02062-3315
Phone
(781) 414-2247
Fax
(781) 352-3996
NPI assigned
Aug 11, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2016

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

Authorized official

Name
Ms. Mary C. Tarvin, LICSWNPI 1689128183
Title
President
Phone
(617) 696-4791

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 114647 MA Primary

Addresses

Primary practice location

1 Walpole St
Suite 1
Norwood, MA 02062-3315

Mailing address

5 Byrne Rd
Milton, MA 02186-1703
Phone (617) 696-4791

Other names 1

  • Mary C. Tarvin, LICSW Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170510000984 MA Part B Supplier - Clinic/Group Practice 8820375371 Receives reassigned benefits from 1 practitioner
Practice locations: Milton, MA; Norwood, MA

National Provider Directory

National Provider Directory

Locations

1 Walpole St
Ste 5
Norwood, MA 02062
Phone (339) 237-2134

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1470873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471046400000",
    "number": "1003360603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 BYRNE RD",
            "city": "MILTON",
            "state": "MA",
            "postal_code": "021861703",
            "telephone_number": "617-696-4791",
            "fax_number": "617-507-8354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WALPOLE ST",
            "address_2": "SUITE 1",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020623315",
            "telephone_number": "781-414-2247",
            "fax_number": "781-352-3996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY C. TARVIN, MSW, LICSW, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-11",
        "last_updated": "2016-08-13",
        "status": "A",
        "authorized_official_last_name": "TARVIN",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-696-4791",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "114647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mary C. Tarvin, LICSW",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Norwood, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.