Individual provider Active NPI

Lauren Manasse-Latham, MSW, LICSW

  • Clinical Social Worker
  • Newton, MA
National Provider Identifier
1013064229
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1020734 Issued in MA
Practice address
3 Thornton St
Newton, MA 02458-1519
Phone
(617) 894-0024
NPI assigned
Jan 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1020734 MA Primary

Addresses

Primary practice location

3 Thornton St
Newton, MA 02458-1519

Mailing address

177 Metropolitan Ave
Roslindale, MA 02131-4228
Phone (617) 363-9988

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
I20051028000370 MA Practitioner - Clinical Social Worker 9638196678 Practice locations: Brookline, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1101 Beacon St
Brookline, MA 02446-5587
Phone 61789400241

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1020734MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013064229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 METROPOLITAN AVE",
            "city": "ROSLINDALE",
            "state": "MA",
            "postal_code": "021314228",
            "telephone_number": "617-363-9988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 THORNTON ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024581519",
            "telephone_number": "617-894-0024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANASSE-LATHAM",
        "first_name": "LAUREN",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1020734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, MA

Sources for this page

Verify at the official NPI Registry.