Immanuel Acevedo
Individual provider Active NPI Clinical Social Worker · Springfield, MA
NPI 1033960844 · NPPES record last updated Mar 29, 2024
Key facts
- NPI
- 1033960844
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- LCSW226638 (MA)
- Practice address
- 60 Ronald Dr
Springfield, MA 01104-1631 - Phone
- (413) 355-3342
- NPI assigned
- Mar 29, 2024
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW226638 | MA | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW226638 | MA | Yes |
Addresses
Primary practice location
60 Ronald Dr
Springfield, MA 01104-1631
Mailing address
60 Ronald Dr
Springfield, MA 01104-1631
Other providers in Springfield, MA
- Accessible Care Inc.
- Accountable Care Clinical Services PC
- Accountable Care Practice Services PC
- Andrea Acevedo
- Hector L Acevedo
- Jerica Acevedo
- Manuel Acevedo
- Deepak Acharya
- Ezra Acholonu
- Brian Acker
All providers in Springfield, MA · Clinical Social Worker in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.