Individual provider Active NPI

Anissa Ali, LICSW

  • Clinical Social Worker
  • Beverly, MA
National Provider Identifier
1194008789
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
800 Cummings Ctr
Suite 266T
Beverly, MA 01915-6175
Phone
(978) 921-1190
Fax
(978) 927-3724
NPI assigned
Sep 21, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

800 Cummings Ctr
Suite 266T
Beverly, MA 01915-6175

Mailing address

1493 Cambridge St
Cambridge, MA 02139-1047
Phone (617) 665-1561

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aaali@challiance.org

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
I20220902000433 MA Practitioner - Clinical Social Worker 1557745916 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cambridge Public Health Commission CurrentSince Aug 9, 2022 Accepting new patients
Cambridge Public Health Commission CurrentSince Aug 9, 2022 Accepting new patients

Locations

1493 Cambridge St
Cambridge, MA 02139
Phone (617) 665-1185

350 Main St
Ste 31
Malden, MA 02148
Phone (781) 397-6583

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.

NPI Registry JSON

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1194008789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1493 CAMBRIDGE ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021391047",
            "telephone_number": "617-665-1561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 CUMMINGS CTR",
            "address_2": "SUITE 266T",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156175",
            "telephone_number": "978-921-1190",
            "fax_number": "978-927-3724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALI",
        "first_name": "ANISSA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-21",
        "last_updated": "2022-09-12",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aaali@challiance.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "1493 Cambridge St",
            "city": "Cambridge",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021391047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

Verify at the official NPI Registry.