Joan E Prugh, MSW,LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

116008 Issued in MA

Practice address

17 Brewster St
Provincetown, MA 02657-1603

Phone

(860) 450-9789

NPI assigned

Oct 3, 2006

Last updated

Jan 16, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1114011160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 BREWSTER ST",
            "city": "PROVINCETOWN",
            "state": "MA",
            "postal_code": "026571603",
            "telephone_number": "860-450-9789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 BREWSTER ST",
            "city": "PROVINCETOWN",
            "state": "MA",
            "postal_code": "026571603",
            "telephone_number": "860-450-9789"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 Sawmill Brook Ln",
            "address_purpose": "LOCATION",
            "city": "Mansfield Center",
            "state": "CT",
            "postal_code": "062501636",
            "country_code": "US",
            "telephone_number": "860-450-9789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRUGH",
        "first_name": "JOAN",
        "middle_name": "E",
        "credential": "MSW,LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "000531",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "116008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica Teresa Paz, DDS
• Edith Pels, LIC. AC.
• Stanley De Oliveira Pimenta, DDS
• Narcis Sebastian Popita
• Provincetown Physical Therapy
• Quest Diagnostics Massachusetts LLC
• Walter M Richter, M.D.
• Aneta Roderick, RN
• Susan H. Roderick, CFNP
• Matthew William Ruble, M.D.

• Clinical Social Worker in Provincetown, MA
• Providers in Provincetown, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.