Laurel Boland, LICSW
Individual provider Active NPI Clinical Social Worker · Southbridge, MA
NPI 1134734965 · NPPES record last updated Sep 23, 2024
Key facts
- NPI
- 1134734965
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Practice address
- 139 South St
Southbridge, MA 01550-4032 - Phone
- (508) 909-7799
- NPI assigned
- Sep 9, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Massachusetts Psychiatric Services LLC
Practice addresses (Care Compare)
258 Main St
Sturbridge, MA 01566-1540
Phone 5084186888206
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240827000285 | MA | Practitioner - Clinical Social Worker | 5799224416 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Massachusetts Psychiatric Services, LLC | Current |
Accepting new patients | |
| Umass Memorial Medical Group Inc | Current |
Accepting new patients | |
| Umass Memorial Medical Group, Inc. | Current |
Accepting new patients |
Locations
258 Main St
Sturbridge, MA 01566
Phone (508) 418-6888
55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Yes |
Addresses
Primary practice location
139 South St
Southbridge, MA 01550-4032
Mailing address
258 Main St
Sturbridge, MA 01566-1540
Phone (508) 418-6888
Other providers in Southbridge, MA
- Elizabeth Bitgood
- Bonnie Sarah Bitran
- Jennifer Blanchet
- Doreen Blouin
- Lauren Boisvert
- Desneiges Bolduc
- Ava Bollig
- Elizabeth Bolshaw
- Danielle Bolster
- Marc L Bonin
All providers in Southbridge, MA · Clinical Social Worker in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 23, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.