Individual provider Active NPI

Melissa Ann Koster, LICSW

  • Clinical Social Worker
  • Malden, MA
National Provider Identifier
1174091870
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
127959 Issued in MA
Practice address
730 Eastern Ave
Malden, MA 02148-5906
Phone
(781) 873-1425
Fax
(781) 395-0198
NPI assigned
Nov 12, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X 127959 MA Primary

Addresses

Primary practice location

730 Eastern Ave
Malden, MA 02148-5906

Mailing address

15 Linnea LN
Reading, MA 01867-1348
Phone (781) 521-0187

Other practice location 1

700 Massachusetts Ave Fl 3
Cambridge, MA 02139-3345
Phone (888) 500-2067

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
I20250415003326 MA Practitioner - Clinical Social Worker 4284159906 Reassigns benefits to 1 organization
Practice locations: Reading, MA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
127959MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cartwheel Health Services PC Mental Health Past Accepting new patients

Organizations & group practices 1

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": "1541980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776124800000",
    "number": "1174091870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 LINNEA LN",
            "city": "READING",
            "state": "MA",
            "postal_code": "018671348",
            "telephone_number": "781-521-0187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 EASTERN AVE",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021485906",
            "telephone_number": "781-873-1425",
            "fax_number": "781-395-0198"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 Massachusetts Ave Fl 3",
            "address_purpose": "LOCATION",
            "city": "Cambridge",
            "state": "MA",
            "postal_code": "021393345",
            "country_code": "US",
            "telephone_number": "888-500-2067",
            "fax_number": "617-649-8520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOSTER",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-12",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "127959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malden, MA

Sources for this page

Verify at the official NPI Registry.