Individual provider Active NPI

Emily Rebecca O'Brien, LICSW

  • Clinical Social Worker
  • Lowell, MA
National Provider Identifier
1114585312
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
124680 Issued in MA
Practice address
1 Hospital Dr
Lowell, MA 01852-1311
Phone
(978) 995-0313
NPI assigned
Jun 3, 2019
Last updated
Oct 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Clinical Social Worker 1041C0700X 124680 MA Primary

Addresses

Primary practice location

1 Hospital Dr
Lowell, MA 01852-1311

Mailing address

800 District Ave
Burlington, MA 01803-5057

Other practice location 1

2 Courthouse Ln Ste 3
Chelmsford, MA 01824-1723
Phone (978) 275-9444

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190725001581 MA Practitioner - Clinical Social Worker 2365778545 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2 Courthouse LN
Suite 3
Chelmsford, MA 01824-1723
Phone (978) 275-9444

21 George St
Suite 300
Lowell, MA 01852-2228
Phone (978) 459-2306

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
124680MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Tmin Services, Inc. CurrentSince Sep 7, 2024 Accepting new patients

Locations

800 District Ave
Ste 520
Burlington, MA 01803
Phone (781) 338-7350

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1559520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1114585312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 DISTRICT AVE",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018035057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018521311",
            "telephone_number": "978-995-0313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Courthouse Ln Ste 3",
            "address_purpose": "LOCATION",
            "city": "Chelmsford",
            "state": "MA",
            "postal_code": "018241723",
            "country_code": "US",
            "telephone_number": "978-275-9444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "EMILY",
        "middle_name": "REBECCA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-03",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "124680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MA

Sources for this page

Verify at the official NPI Registry.