Individual provider Active NPI

Elizabeth Marie Templeton, LCSW

  • Clinical Social Worker
  • Boston, MA
National Provider Identifier
1124273131
Registry record updated Nov 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
115613 Issued in MA
Practice address
75 Fenwood Rd
Mass. Mental Health Center
Boston, MA 02115-6103
Phone
(617) 626-9464
Fax
(617) 626-9578
NPI assigned
Nov 19, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 115613 MA Primary

Addresses

Primary practice location

75 Fenwood Rd
Mass. Mental Health Center
Boston, MA 02115-6103

Mailing address

75 Fenwood Rd
Mass. Mental Health Center
Boston, MA 02115-6103
Phone (617) 626-9464

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
I20121121000413 MA Practitioner - Clinical Social Worker 7719138767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Commonwealth of MassachusettsGroup PAC ID 8820906860, 141 clinicians

Practice addresses (Care Compare)

75 Fenwood Rd
Boston, MA 02115-6103
Phone (617) 626-9300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
115613MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Commonwealth of Massachusetts CurrentSince Sep 13, 2012 Accepting new patients
The Commonwealth of Massachusetts CurrentSince Sep 13, 2012 Accepting new patients
The Commonwealth of Massachusetts Current Accepting new patients

Locations

75 Fenwood Rd
Boston, MA 02115
Phone (617) 626-9300

85 Newton St
Boston, MA 02118
Phone (617) 305-9960

76 Amory St
Roxbury, MA 02119
Phone (617) 626-9300

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1227052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479686400000",
    "number": "1124273131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 FENWOOD RD",
            "address_2": "MASS. MENTAL HEALTH CENTER",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156103",
            "telephone_number": "617-626-9464",
            "fax_number": "617-626-9578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FENWOOD RD",
            "address_2": "MASS. MENTAL HEALTH CENTER",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156103",
            "telephone_number": "617-626-9464",
            "fax_number": "617-626-9578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEMPLETON",
        "first_name": "ELIZABETH",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-19",
        "last_updated": "2016-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "115613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.