Individual provider Active NPI

Orli Hersey, LICSW

  • Clinical Social Worker
  • Fitchburg, MA
National Provider Identifier
1215007463
Registry record updated Sep 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
115516 Issued in MA
Practice address
326 Nichols Rd
Fitchburg, MA 01420-1914
Phone
(978) 878-8440
Fax
(978) 878-8535
NPI assigned
Nov 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X
Clinical Social Worker 1041C0700X 115516 MA Primary

Addresses

Primary practice location

326 Nichols Rd
Fitchburg, MA 01420-1914

Mailing address

326 Nichols Rd
Fitchburg, MA 01420-1914
Phone (978) 878-8100

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
I20100727000558 MA Practitioner - Clinical Social Worker 3375676430 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
May accept Medicare assignment
Group practices
Community Health Connections, IncGroup PAC ID 8729074992, 91 clinicians

Practice addresses (Care Compare)

165 Mill St
Leominster, MA 01453-3289
Phone (978) 878-8100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
115516MAMDClinical Social Worker

Interoperability endpoints

  • Direct secure messaging: orli.hersey.p1@direct.chcfhc.nextgenshare.com

Organizations & group practices 5

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443571200000",
    "number": "1215007463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 NICHOLS RD",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014201914",
            "telephone_number": "978-878-8100",
            "fax_number": "978-878-8418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 NICHOLS RD",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014201914",
            "telephone_number": "978-878-8440",
            "fax_number": "978-878-8535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERSEY",
        "first_name": "ORLI",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2015-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "115516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fitchburg, MA

Sources for this page

Verify at the official NPI Registry.