Individual provider Active NPI

Donna Martel, LICSW

  • Clinical Social Worker
  • Brockton, MA
National Provider Identifier
1053630095
Registry record updated May 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
116634 Issued in MA
Practice address
10 Meadowbrook Rd
Brockton, MA 02301-7122
Phone
(508) 774-4424
NPI assigned
May 28, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Clinical Social Worker 1041C0700X 116634 MA Primary

Addresses

Primary practice location

10 Meadowbrook Rd
Brockton, MA 02301-7122

Mailing address

10 Meadowbrook Rd
Brockton, MA 02301-7122
Phone (508) 742-4419

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
I20120430000512 MA Practitioner - Clinical Social Worker 9133381668 Practice locations: South Easton, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

South Easton, MA 02375
Phone (508) 944-3138

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
High Point Treatment Center Inc. Past Accepting new patients

Organizations & group practices 1

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": "1275004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337040000000",
    "number": "1053630095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 MEADOWBROOK RD",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023017122",
            "telephone_number": "508-742-4419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MEADOWBROOK RD",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023017122",
            "telephone_number": "508-774-4424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTEL",
        "first_name": "DONNA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-28",
        "last_updated": "2012-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "116634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.