Individual provider Active NPI

Maria Rose, LICSW

  • Clinical Social Worker
  • Burlington, MA
National Provider Identifier
1063742575
Registry record updated Apr 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
117551 Issued in MA
Practice address
1500 District Ave Ste 1063
Burlington, MA 01803-5069
Phone
(978) 201-1286
NPI assigned
Jan 5, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 216119 MA
Clinical Social Worker 1041C0700X 117551 MA Primary

Addresses

Primary practice location

1500 District Ave Ste 1063
Burlington, MA 01803-5069

Mailing address

1500 District Ave Ste 1063
Burlington, MA 01803-5069
Phone (978) 201-1286

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
I20260511003305 MA Practitioner - Clinical Social Worker 8325516073 Practice locations: Beverly, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

111 Middlesex Tpke
Suite 1101
Burlington, MA 01803-4901

111 Middlesex Tpke
Suite 1101
Burlington, MA 01803-4905

131 McKay St
Apt 129
Beverly, MA 01915-3057
Phone (978) 201-1286

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
216119MAMDSocial Worker
117551MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1262649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554681600000",
    "number": "1063742575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 DISTRICT AVE STE 1063",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018035069",
            "telephone_number": "978-201-1286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 DISTRICT AVE STE 1063",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018035069",
            "telephone_number": "978-201-1286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "MARIA",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-05",
        "last_updated": "2019-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "216119",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "117551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, MA

Sources for this page

Verify at the official NPI Registry.