Individual provider Active NPI

Michael John Wiehe, MSW

  • Clinical Social Worker
  • Woburn, MA
National Provider Identifier
1013295930
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
118285 Issued in MA
Practice address
12 Alfred St Ste 200203
Woburn, MA 01801-1972
Phone
(619) 823-6775
NPI assigned
Jul 26, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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 118285 MA Primary

Addresses

Primary practice location

12 Alfred St Ste 200203
Woburn, MA 01801-1972

Mailing address

12 Alfred St Ste 200203
Woburn, MA 01801-1972
Phone (619) 823-6775

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
I20150225000078 MA Practitioner - Clinical Social Worker 0143546812 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Child and Family Psychological Services PLLCGroup PAC ID 5991763823, 260 clinicians

Practice addresses (Care Compare)

12 Alfred St
Suite 200
Woburn, MA 01801-1915
Phone (781) 646-0500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wilmington Family Counseling Service Inc CurrentSince Jul 1, 2014 Accepting new patients
Child and Family Psychological Services, PLLC Clinical CurrentSince Feb 24, 2020 Accepting new patients

Locations

89 Access Rd
Ste 24
Norwood, MA 02062
Phone (781) 336-5040

5 Middlesex Ave
Unit 11
Wilmington, MA 01887
Phone (978) 658-9889

12 Alfred St
Ste 200
Woburn, MA 01801
Phone 7816460500 ext. 112

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1311638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1013295930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 ALFRED ST STE 200203",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018011972",
            "telephone_number": "619-823-6775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 ALFRED ST STE 200203",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018011972",
            "telephone_number": "619-823-6775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEHE",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-26",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "118285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

Verify at the official NPI Registry.