Individual provider Active NPI

Lynne Chevalier-Ray, LICSW

  • Clinical Social Worker
  • Medford, MA
National Provider Identifier
1104055664
Registry record updated Jul 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
114147 Issued in MA
Practice address
10 Cabot Rd
Suite 209
Medford, MA 02155-5177
Phone
(781) 395-0257
NPI assigned
Jul 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2009

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 114147 MA Primary

Addresses

Primary practice location

10 Cabot Rd
Suite 209
Medford, MA 02155-5177

Mailing address

10 Cabot Rd
Suite 209
Medford, MA 02155-5177
Phone (781) 395-0257

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

LicenseStateTypeSpecialty
114147MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1246838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246838400000",
    "number": "1104055664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CABOT RD",
            "address_2": "SUITE 209",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021555177",
            "telephone_number": "781-395-0257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CABOT RD",
            "address_2": "SUITE 209",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021555177",
            "telephone_number": "781-395-0257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEVALIER-RAY",
        "first_name": "LYNNE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-06",
        "last_updated": "2009-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "114147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.