Individual provider Active NPI

Marygina Stilwell

  • Social Worker
  • Boston, MA
National Provider Identifier
1215410758
Registry record updated Sep 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
105443 Issued in MA
Practice address
90 Warren Ave
Boston, MA 02116-6105
Phone
(617) 635-9976
NPI assigned
Sep 11, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 105443 MA Primary

Addresses

Primary practice location

90 Warren Ave
Boston, MA 02116-6105

Mailing address

PO Box 255
Green Harbor, MA 02041-0255

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
105443MAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536624000000",
    "number": "1215410758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255",
            "city": "GREEN HARBOR",
            "state": "MA",
            "postal_code": "020410255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 WARREN AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021166105",
            "telephone_number": "617-635-9976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILWELL",
        "first_name": "MARYGINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-11",
        "last_updated": "2018-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "105443",
            "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 Sep 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.