Individual provider Active NPI

Michael Lee Taylor, LICSW

  • Clinical Social Worker
  • Brewster, MA
National Provider Identifier
1205925450
Registry record updated Sep 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1031070 Issued in MA
Practice address
23-25 Bay State Court
Brewster, MA 02631
Phone
(508) 240-7964
Fax
(508) 240-5448
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2011

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 1031070 MA Primary

Addresses

Primary practice location

23-25 Bay State Court
Brewster, MA 02631

Mailing address

23-25 Bay State Court
Brewster, MA 02631
Phone (508) 240-7964

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
I20050930000482 MA Practitioner - Clinical Social Worker 5294760963 Practice locations: Brewster, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

23 -25 Bay State Court
Brewster, MA 02631

23 Bay State Court
Suite 25
Brewster, MA 02631
Phone 5082407964217

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1031070MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1205925450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23-25 BAY STATE COURT",
            "city": "BREWSTER",
            "state": "MA",
            "postal_code": "02631",
            "telephone_number": "508-240-7964",
            "fax_number": "508-240-5448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23-25 BAY STATE COURT",
            "city": "BREWSTER",
            "state": "MA",
            "postal_code": "02631",
            "telephone_number": "508-240-7964",
            "fax_number": "508-240-5448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "MICHAEL",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1031070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brewster, MA

Sources for this page

Verify at the official NPI Registry.