Active NPI
Angela Jachym
- Clinical Social Worker
- Granby, MA
National Provider Identifier
1083492060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW03364
- Practice address
- 160 Harris St
Granby, MA 01033-9797 - Phone
- (413) 531-2464
- NPI assigned
- Sep 20, 2023
- Last updated
- Sep 20, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 150.111049 | IL | |
| Clinical Social Worker | 1041C0700X | CSW03364 | RI | Primary |
Addresses
Primary practice location
160 Harris St
Granby, MA 01033-9797
Mailing address
160 Harris St
Granby, MA 01033-9797
Phone (413) 531-2464
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 |
|---|---|---|---|
| 150.111049 | IL | MD | Clinical Social Worker |
| CSW03364 | RI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695168000000",
"number": "1083492060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "160 HARRIS ST",
"city": "GRANBY",
"state": "MA",
"postal_code": "010339797",
"telephone_number": "413-531-2464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "160 HARRIS ST",
"city": "GRANBY",
"state": "MA",
"postal_code": "010339797",
"telephone_number": "413-531-2464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACHYM",
"first_name": "ANGELA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-20",
"last_updated": "2023-09-20",
"certification_date": "2023-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "150.111049",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "RI",
"license": "CSW03364",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Granby, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.