Individual provider Active NPI

Elyse Balder, LICSW

  • Clinical Social Worker
  • Framingham, MA
National Provider Identifier
1184720336
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1016273 Issued in MA
Practice address
14 Vernon St
Suite 206
Framingham, MA 01701-4733
Phone
(617) 775-7026
NPI assigned
Sep 15, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1016273 MA Primary

Addresses

Primary practice location

14 Vernon St
Suite 206
Framingham, MA 01701-4733

Mailing address

14 Vernon St
Suite 206
Framingham, MA 01701-4733
Phone (617) 775-7026

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
I20050930000535 MA Practitioner - Clinical Social Worker 0244265916 Practice locations: Framingham, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

32 Marant Dr
Needham, MA 02492-2774

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1016273MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184720336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 VERNON ST",
            "address_2": "SUITE 206",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017014733",
            "telephone_number": "617-775-7026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 VERNON ST",
            "address_2": "SUITE 206",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017014733",
            "telephone_number": "617-775-7026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALDER",
        "first_name": "ELYSE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1016273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Framingham, MA

Sources for this page

Verify at the official NPI Registry.