Individual provider Active NPI

Madennys Maria, LCSW

  • Clinical Social Worker
  • Methuen, MA
National Provider Identifier
1083123897
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW229182 Issued in MA
Practice address
147 Pelham St
Methuen, MA 01844-2060
Phone
(978) 683-3491
Fax
(978) 683-3058
NPI assigned
Sep 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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 LCSW229182 MA Primary

Addresses

Primary practice location

147 Pelham St
Methuen, MA 01844-2060

Mailing address

34 Haverhill St
Lawrence, MA 01841-2884
Phone (978) 686-0090

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
I20230601002966 MA Practitioner - Clinical Social Worker 0840657003 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Lawrence Family Health Center, Inc. CurrentSince May 23, 2023 Accepting new patients
Greater Lawrence Family Health Center Inc CurrentSince May 23, 2023 Accepting new patients
Greater Lawrence Family Health Center, Inc. Current Accepting new patients

Locations

150 Park St
Lawrence, MA 01841
Phone (978) 685-1770

34 Haverhill St
Lawrence, MA 01841

147 Pelham St
Methuen, MA 01844
Phone (978) 683-3491

Organizations & group practices 3

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": "1506297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1083123897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 HAVERHILL ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018412884",
            "telephone_number": "978-686-0090",
            "fax_number": "978-681-5963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 PELHAM ST",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018442060",
            "telephone_number": "978-683-3491",
            "fax_number": "978-683-3058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIA",
        "first_name": "MADENNYS",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-25",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "LCSW229182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Methuen, MA

Sources for this page

Verify at the official NPI Registry.