Active NPI
Maylene Victoria Collado-Wulff, LICSW
- Clinical Social Worker
- Lynn, MA
National Provider Identifier
1033352539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 20 Central Ave
Lynn, MA 01901 - Phone
- (781) 586-6691
- NPI assigned
- Apr 13, 2009
- Last updated
- Nov 21, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
20 Central Ave
Lynn, MA 01901
Mailing address
PO Box 526
Lynn, MA 01901
Phone (781) 581-3900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033352539 | Medicaid | MA |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574294400000",
"number": "1033352539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 526",
"city": "LYNN",
"state": "MA",
"postal_code": "01901",
"telephone_number": "781-581-3900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 CENTRAL AVE",
"city": "LYNN",
"state": "MA",
"postal_code": "01901",
"telephone_number": "781-586-6691"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLADO-WULFF",
"first_name": "MAYLENE",
"middle_name": "VICTORIA",
"name_prefix": "Mrs.",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-04-13",
"last_updated": "2019-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1033352539",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lynn, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.