Erick Banuelos, M.A., LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

120253 Issued in MA

Practice address

73D Winthrop Ave
Lawrence, MA 01843-3716

Phone

(978) 686-0090

NPI assigned

Sep 10, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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

{
    "created_epoch": "1347235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510185600000",
    "number": "1013266790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73D WINTHROP AVE",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018433716",
            "telephone_number": "978-686-3017",
            "fax_number": "978-685-4280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73D WINTHROP AVE",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018433716",
            "telephone_number": "978-686-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANUELOS",
        "first_name": "ERICK",
        "credential": "M.A., LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-10",
        "last_updated": "2017-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "120253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Balogna
• Nicolas Baltayan
• Nicole Banderas-Gonzalez, RN
• Donna Lee Bandilla, RN-BC
• Banessa Gonell LLC
• Jahicol Alexander Baralt
• Cecile R Baranowski, CRNA
• Lucille Barberian, BA
• Elizabeth Barbosa
• Prudence Barker, NP

• Clinical Social Worker in Lawrence, MA
• Providers in Lawrence, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.