Individual provider Active NPI

Lynette Ann Dunn-Nastasi, LICSW

  • Clinical Social Worker
  • Medway, MA
National Provider Identifier
1194881086
Registry record updated Mar 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
111675 Issued in MA
Practice address
165 Main St Unit 108
Medway, MA 02053-1584
Phone
(774) 641-3568
Fax
(508) 377-5835
NPI assigned
Dec 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2019

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 111675 MA Primary

Addresses

Primary practice location

165 Main St Unit 108
Medway, MA 02053-1584

Mailing address

165 Main St Unit 108
Medway, MA 02053-1584
Phone (774) 641-3568

Other identifiers 1

IdentifierTypeStateIssuer
111675OtherMASOCIAL WORK LICENSE

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
I20040802000791 MA Practitioner - Clinical Social Worker 8921079211 Practice locations: Medway, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

165 Main St
Suite 108
Medway, MA 02053-1584
Phone (774) 641-3568

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wayside Youth and Family Support Network PastSince Jan 30, 2025 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": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552003200000",
    "number": "1194881086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 MAIN ST UNIT 108",
            "city": "MEDWAY",
            "state": "MA",
            "postal_code": "020531584",
            "telephone_number": "774-641-3568",
            "fax_number": "508-377-5835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 MAIN ST UNIT 108",
            "city": "MEDWAY",
            "state": "MA",
            "postal_code": "020531584",
            "telephone_number": "774-641-3568",
            "fax_number": "508-377-5835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNN-NASTASI",
        "first_name": "LYNETTE",
        "middle_name": "ANN",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2019-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "111675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL WORK LICENSE",
            "identifier": "111675",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medway, MA

Sources for this page

Verify at the official NPI Registry.