Active NPI
Olivia Anjeannette Amadon, LICSW
- Clinical Social Worker
- East Boston, MA
National Provider Identifier
1174987804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LICSW121568
- Practice address
- 10 Gove St
East Boston, MA 02128-1920 - Phone
- (617) 569-5800
- NPI assigned
- Apr 8, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| Clinical Social Worker | 1041C0700X | LICSW121568 | MA | Primary |
Addresses
Primary practice location
10 Gove St
East Boston, MA 02128-1920
Mailing address
10 Gove St
East Boston, MA 02128-1920
Phone (617) 569-5800
Other practice location 1
45 Dimock St
Roxbury, MA 02119-1208
Phone (617) 442-4088
Other practice location 2
1601 Washington St
Boston, MA 02118-1951
Phone (617) 425-2000
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170405002211 | MA | Practitioner - Clinical Social Worker | 0547546566 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Internal Medical Associates-Ebnhc
Practice addresses (Care Compare)
10 Gove St
East Boston, MA 02128-1920
Phone (617) 569-5800
Hospital & facility affiliations
- Boston Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LICSW121568 | MA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Associates of Ebnhc | Current | Accepting new patients | |
| Internal Medical Associates-Ebnhc | Current | Accepting new patients |
Locations
1601 Washington St
Boston, MA 02118
Phone (617) 425-2000
10 Grove St
East Boston, MA 02128
Phone (617) 569-5800
Interoperability endpoints
- oamadon43738@direct.neighborhealth.masshiway.net
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 and National Provider Directory roles.
-
- Community Health Clinic/Center
- East Boston, MA
- NPI 1255451597
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Community Health Clinic/Center
- South Boston, MA
- NPI 1225228679
Hospital
-
- Community Health Clinic/Center
- Roslindale, MA
- NPI 1386718823
Hospital
-
- Community Health Clinic/Center
- Dorchester, MA
- NPI 1780874677
Hospital
-
- Community Health Clinic/Center
- East Boston, MA
- NPI 1861683518
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739404800000",
"number": "1174987804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 GOVE ST",
"city": "EAST BOSTON",
"state": "MA",
"postal_code": "021281920",
"telephone_number": "617-569-5800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 GOVE ST",
"city": "EAST BOSTON",
"state": "MA",
"postal_code": "021281920",
"telephone_number": "617-569-5800"
}
],
"practiceLocations": [
{
"address_1": "45 Dimock St",
"address_purpose": "LOCATION",
"city": "Roxbury",
"state": "MA",
"postal_code": "021191208",
"country_code": "US",
"telephone_number": "617-442-4088",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1601 Washington St",
"address_purpose": "LOCATION",
"city": "Boston",
"state": "MA",
"postal_code": "021181951",
"country_code": "US",
"telephone_number": "617-425-2000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "AMADON",
"first_name": "OLIVIA",
"middle_name": "ANJEANNETTE",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-08",
"last_updated": "2025-02-13",
"certification_date": "2025-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "LICSW121568",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.