Individual provider Active NPI

Emily Walsh, LICSW

  • Clinical Social Worker
  • Plymouth, MA
National Provider Identifier
1073874848
Registry record updated Apr 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
119346 Issued in MA
Practice address
64 Industrial Park Rd
Plymouth, MA 02360-4881
Phone
(508) 747-7032
NPI assigned
Jun 7, 2012
Last updated
Apr 1, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 119346 MA Primary

Addresses

Primary practice location

64 Industrial Park Rd
Plymouth, MA 02360-4881

Mailing address

64 Industrial Park Rd
Plymouth, MA 02360-4881
Phone (508) 747-7032

Other practice location 1

42 Fiddlers Cove Rd
North Falmouth, MA 02556-2317
Phone (508) 747-7032

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
I20160304001610 MA Practitioner - Clinical Social Worker 0345546107 Practice locations: Bourne, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Bourne, MA 02532
Phone (508) 289-1011

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": "1339027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554076800000",
    "number": "1073874848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 INDUSTRIAL PARK RD",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023604881",
            "telephone_number": "508-747-7032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 INDUSTRIAL PARK RD",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023604881",
            "telephone_number": "508-747-7032"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "42 Fiddlers Cove Rd",
            "address_purpose": "LOCATION",
            "city": "North Falmouth",
            "state": "MA",
            "postal_code": "025562317",
            "country_code": "US",
            "telephone_number": "508-747-7032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALSH",
        "first_name": "EMILY",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-07",
        "last_updated": "2019-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "119346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

Verify at the official NPI Registry.