Elizabeth Taleas Southall, LICSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

212052 Issued in MA

Practice address

720 Washington St Ste 603
Hanover, MA 02339-2476

Phone

(617) 306-2748

NPI assigned

Dec 11, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2002

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Life Enhancement Psychotherapy LLC

  • Clinical Psychologist
  • Hanover, MA
  • NPI 1578862272

  Social Worker

  NPD

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634601600000",
    "number": "1225211436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 934",
            "city": "HANOVER",
            "state": "MA",
            "postal_code": "023390934",
            "telephone_number": "617-552-5124",
            "fax_number": "888-317-2641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 WASHINGTON ST STE 603",
            "city": "HANOVER",
            "state": "MA",
            "postal_code": "023392476",
            "telephone_number": "617-306-2748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHALL",
        "first_name": "ELIZABETH",
        "middle_name": "TALEAS",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-11",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "212052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Shore Midwifery
• South Shore Midwifery & Gynecology, LLC
• South Shore OB-GYN Hanover OB-GYN Inc
• South Shore Primary and Urgent Care LLC
• South Shore Regional Voc TCH School
• Robert Spitz
• Yeemay Su, RD
• Ann Sullivan, NP
• Brian P Sullivan, MD
• Kathleen Anne Sullivan, NP

• Social Worker in Hanover, MA
• Providers in Hanover, MA by specialty
• Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.