Wendy Ackley

Individual provider Active NPI Clinical Social Worker · Auburn, MA

NPI 1104366129 · NPPES record last updated Apr 8, 2021

Key facts

NPI
1104366129
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
111634 (MA)
Practice address
67 School Street
Auburn, MA 01501
Phone
(774) 318-8842
NPI assigned
Feb 24, 2017
Sex
Female
Sole proprietor
Yes

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

67 School St
Auburn, MA 01501-2929
Phone (774) 318-8842

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20180521001227 MA Practitioner - Clinical Social Worker 0042575185 Practice locations: Auburn, MA

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 111634 MA
Clinical Social Worker 1041C0700X 111634 MA Yes

Addresses

Primary practice location

67 School Street
Auburn, MA 01501

Mailing address

P.O. Box 133
Manchaug, MA 01526
Phone (774) 318-8842

Other providers in Auburn, MA

All providers in Auburn, MA · Clinical Social Worker in Massachusetts

Sources for this page

Verify at the official NPI Registry.