Nancy Palchanis Funderburg, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

215268 Issued in MA

Practice address

20 Vesper LN Unit L1
Nantucket Behavioral Health Services
Nantucket, MA 02554-4394

Phone

(508) 228-2689

Fax

(508) 228-3613

NPI assigned

Oct 28, 2008

Last updated

Oct 28, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Fairwinds-Nantucket's Counseling Center, Inc

  • Developmental - Behavioral Pediatrics Physician
  • Nantucket, MA
  • NPI 1629537444
  NPD (past)
• Fairwinds-Nantuckets Counseling Center

  • Community/Behavioral Health Agency
  • Nantucket, MA
  • NPI 1275621385
  NPD (past)

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225152000000",
    "number": "1124271788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 VESPER LN UNIT L1",
            "address_2": "NANTUCKET BEHAVIORAL HEALTH SERVICES",
            "city": "NANTUCKET",
            "state": "MA",
            "postal_code": "025544394",
            "telephone_number": "508-228-2689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 VESPER LN UNIT L1",
            "address_2": "NANTUCKET BEHAVIORAL HEALTH SERVICES",
            "city": "NANTUCKET",
            "state": "MA",
            "postal_code": "025544394",
            "telephone_number": "508-228-2689",
            "fax_number": "508-228-3613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNDERBURG",
        "first_name": "NANCY",
        "middle_name": "PALCHANIS",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-28",
        "last_updated": "2008-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "215268",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "215268",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlin Rose Flynn
• Bryan Frascati, M.S., LMHC, LPC
• Heather Lynne Freeman, M.S. CCC/SLP
• Suzanne Marguerite Fronzuto
• Mayo R Funderburg II, LADCA
• Jessica Pierce Gage, O.D.
• Renee Elizabeth Gamberoni
• Michael Roger Garrett, MSC HONS P.T.
• Allison Gayo
• Suzanne Gerardi, PT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; 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.