Individual provider Active NPI

Edith Alexandra Spurlock, LCSW

  • Social Worker
  • Boston, MA
National Provider Identifier
1013264340
Registry record updated Jan 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
220327 Issued in MA
Practice address
130 Condor St
Boston, MA 02128-1305
Phone
(617) 912-7646
Fax
(617) 569-1856
NPI assigned
Aug 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 220327 MA Primary

Addresses

Primary practice location

130 Condor St
Boston, MA 02128-1305

Mailing address

130 Condor St
Boston, MA 02128-1305
Phone (617) 912-7646

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
220327MAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1344211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420156800000",
    "number": "1013264340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 CONDOR ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021281305",
            "telephone_number": "617-912-7646",
            "fax_number": "617-569-1856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 CONDOR ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021281305",
            "telephone_number": "617-912-7646",
            "fax_number": "617-569-1856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPURLOCK",
        "first_name": "EDITH",
        "middle_name": "ALEXANDRA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-06",
        "last_updated": "2015-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "220327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2015; 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.