Active NPI
Beverly Iwanicki, MSCASOTR/L
- Occupational Therapist
- Danvers, MA
National Provider Identifier
1043401649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5205
- Practice address
- 6 Crane St
Danvers, MA 01923-3014 - Phone
- (197) 877-7853
- NPI assigned
- Aug 7, 2007
- Last updated
- Aug 7, 2007
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 5205 | MA | Primary |
Addresses
Primary practice location
6 Crane St
Danvers, MA 01923-3014
Mailing address
6 Crane St
Danvers, MA 01923-3014
Phone (197) 877-7853
Other names 1
- Beverly Agrella
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5205 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186444800000",
"number": "1043401649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 CRANE ST",
"city": "DANVERS",
"state": "MA",
"postal_code": "019233014",
"telephone_number": "197-877-7853"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 CRANE ST",
"city": "DANVERS",
"state": "MA",
"postal_code": "019233014",
"telephone_number": "197-877-7853"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IWANICKI",
"first_name": "BEVERLY",
"credential": "MSCASOTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-07",
"last_updated": "2007-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MA",
"license": "5205",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "BEVERLY",
"last_name": "AGRELLA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Danvers, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.