Active NPI
Georgiana Logan, LICSW
- Social Worker
- Boston, MA
National Provider Identifier
1215089917
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 47320
- Practice address
- 1601 Washington Street
Boston, MA 02118 - Phone
- (617) 425-2040
- Fax
- (617) 425-2043
- NPI assigned
- Jan 16, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 47320 | Primary |
Addresses
Primary practice location
1601 Washington Street
Boston, MA 02118
Mailing address
860 Beacon Street
Newton Centre, MA 02459
Phone (617) 306-3646
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215089917",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "860 BEACON STREET",
"city": "NEWTON CENTRE",
"state": "MA",
"postal_code": "02459",
"telephone_number": "617-306-3646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 WASHINGTON STREET",
"city": "BOSTON",
"state": "MA",
"postal_code": "02118",
"telephone_number": "617-425-2040",
"fax_number": "617-425-2043"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOGAN",
"first_name": "GEORGIANA",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": "47320",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.