Active NPI
Ellen Louise Queeney, LICSW
- Clinical Social Worker
- Centerville, MA
National Provider Identifier
1093851834
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 113404
- Practice address
- 158 Scudder Bay Cir
Centerville, MA 02632-3345 - Phone
- (508) 221-7757
- NPI assigned
- Jan 29, 2007
- Last updated
- Sep 1, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 113404 | MA | Primary |
Addresses
Primary practice location
158 Scudder Bay Cir
Centerville, MA 02632-3345
Mailing address
158 Scudder Bay Cir
Centerville, MA 02632-3345
Phone (508) 221-7757
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 16, 2023 through Oct 16, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 113404 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409529600000",
"number": "1093851834",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "158 SCUDDER BAY CIR",
"city": "CENTERVILLE",
"state": "MA",
"postal_code": "026323345",
"telephone_number": "508-221-7757"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "158 SCUDDER BAY CIR",
"city": "CENTERVILLE",
"state": "MA",
"postal_code": "026323345",
"telephone_number": "508-221-7757"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUEENEY",
"first_name": "ELLEN",
"middle_name": "LOUISE",
"name_prefix": "Ms.",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-29",
"last_updated": "2014-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "113404",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Centerville, MA
- Physical Therapy Solutions LLC (Physical Therapy Solutions)
- Physiotherapy Associates Inc (Physiotherapy Associates)
- Marlene Carol Pinskypanish
- Courtney Poignand, M.S.
- Jacqueline Provenzano, LCSW
- Sabrina Lira Ribeiro, NP, FNP
- Shelby Catherine Riley, MSW, LICSW
- Samuel Rosier, DPT
- Elizabeth A Santos, BA
- Kristina Lynn Schmidt, FNP-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.