Individual provider Active NPI

Daniel Peter Norris, LCSW

  • Clinical Social Worker
  • Nantucket, MA
National Provider Identifier
1225339245
Registry record updated Jan 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
217921 Issued in MA
Practice address
20 Vesper LN
L-1 Gouin Village
Nantucket, MA 02554-4394
Phone
(508) 228-2689
Fax
(508) 228-3613
NPI assigned
Nov 8, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Clinical Social Worker 1041C0700X 217921 MA Primary

Addresses

Primary practice location

20 Vesper LN
L-1 Gouin Village
Nantucket, MA 02554-4394

Mailing address

20 Vesper LN
L-1 Gouin Village
Nantucket, MA 02554-4394
Phone (508) 228-2689

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
217921MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Pathology Partners, P.C. Current Accepting new patients
Fairwinds-Nantuckets Counseling Center CurrentSince Mar 21, 2022 Accepting new patients
Fairwinds-Nantucket's Counseling Center, Inc PastSince Jan 12, 2020 Accepting new patients

Locations

20 Vesper Ln
Unit L1
Nantucket, MA 02554
Phone (508) 228-2689

81 Highland Ave
Salem, MA 01970
Phone (978) 354-4009

Organizations & group practices 3

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": "1289174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578528000000",
    "number": "1225339245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 VESPER LN",
            "address_2": "L-1 GOUIN VILLAGE",
            "city": "NANTUCKET",
            "state": "MA",
            "postal_code": "025544394",
            "telephone_number": "508-228-2689",
            "fax_number": "508-228-3613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 VESPER LN",
            "address_2": "L-1 GOUIN VILLAGE",
            "city": "NANTUCKET",
            "state": "MA",
            "postal_code": "025544394",
            "telephone_number": "508-228-2689",
            "fax_number": "508-228-3613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORRIS",
        "first_name": "DANIEL",
        "middle_name": "PETER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-08",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "217921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nantucket, MA

Sources for this page

Verify at the official NPI Registry.