Marissa Shallcross, LICSW

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

120 Boylston Street
Boston, MA 02116

Phone

(617) 824-8586

NPI assigned

Aug 16, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Marissa Capineri Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1534377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534377600000",
    "number": "1114407467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 JEFFERSON ST",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020263613",
            "telephone_number": "617-824-8586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 BOYLSTON STREET",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02116",
            "telephone_number": "617-824-8586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHALLCROSS",
        "first_name": "MARISSA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-16",
        "last_updated": "2018-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NO INSURANCE",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "CAPINERI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Social Worker in Boston, MA
• Providers in Boston, MA by specialty
• Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2018; 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.