Organization Active NPI

McCool Psychotherapy LLC

  • Clinical Social Worker
  • Andover, MA
National Provider Identifier
1013555820
Registry record updated Dec 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MCCOOL PSYCHOTHERAPY LLC
Practice address
93 Main St Ste 213
Andover, MA 01810-3847
Phone
(978) 885-2278
Fax
(978) 685-8233
NPI assigned
Dec 12, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2019

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

Authorized official

Name
Deborah McCool, LICSWNPI 1215245923
Title
Owner
Phone
(978) 885-2278

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 Primary

Addresses

Primary practice location

93 Main St Ste 213
Andover, MA 01810-3847

Mailing address

4 Maple Ridge Rd
Methuen, MA 01844-4166
Phone (978) 885-2278

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200313001168 MA Part B Supplier - Clinic/Group Practice 7214365816 Receives reassigned benefits from 1 practitioner
Practice locations: Methuen, MA

National Provider Directory

National Provider Directory

Locations

93 Main St
Ste 213
Andover, MA 01810
Phone (978) 880-8968

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1576108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576108800000",
    "number": "1013555820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 MAPLE RIDGE RD",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018444166",
            "telephone_number": "978-885-2278",
            "fax_number": "978-685-8233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 MAIN ST STE 213",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018103847",
            "telephone_number": "978-885-2278",
            "fax_number": "978-685-8233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCOOL PSYCHOTHERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-12",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A",
        "authorized_official_last_name": "MCCOOL",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "978-885-2278",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; 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.