Individual provider Active NPI

Marci Susan Shapiro-Ide, LICSW

  • Clinical Social Worker
  • Arlington, MA
National Provider Identifier
1235612904
Registry record updated Sep 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
114348-SW-LICSW Issued in MA
Practice address
Arlington Council on Aging, 27 Maple Street
Arlington, MA 02476
Phone
(781) 316-3419
NPI assigned
Sep 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 114348-SW-LICSW MA Primary

Addresses

Primary practice location

Arlington Council on Aging, 27 Maple Street
Arlington, MA 02476

Mailing address

Arlington Council on Aging
27 Maple Street
Arlington, MA 02476
Phone (781) 316-3400

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
114348-SW-LICSWMAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1536537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536537600000",
    "number": "1235612904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ARLINGTON COUNCIL ON AGING",
            "address_2": "27 MAPLE STREET",
            "city": "ARLINGTON",
            "state": "MA",
            "postal_code": "02476",
            "telephone_number": "781-316-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ARLINGTON COUNCIL ON AGING, 27 MAPLE STREET",
            "city": "ARLINGTON",
            "state": "MA",
            "postal_code": "02476",
            "telephone_number": "781-316-3419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPIRO-IDE",
        "first_name": "MARCI",
        "middle_name": "SUSAN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-10",
        "last_updated": "2018-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "114348-SW-LICSW",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.