Individual provider Active NPI

Mia Perlman, LCSW, LICSW

  • Clinical Social Worker
  • Somerville, MA
National Provider Identifier
1235623125
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149025919 Issued in IL
Practice address
519 Somerville Ave # 336
Somerville, MA 02143-3347
Phone
(617) 684-5144
NPI assigned
Jun 14, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X 000123138 MA
Clinical Social Worker 1041C0700X 149025919 IL Primary

Addresses

Primary practice location

519 Somerville Ave # 336
Somerville, MA 02143-3347

Mailing address

519 Somerville Ave # 336
Somerville, MA 02143-3347
Phone (617) 684-5144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 18, 2026 through Jan 18, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149025919ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1235623125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 SOMERVILLE AVE # 336",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021433347",
            "telephone_number": "617-684-5144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 SOMERVILLE AVE # 336",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021433347",
            "telephone_number": "617-684-5144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERLMAN",
        "first_name": "MIA",
        "credential": "LCSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-14",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "000123138",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149025919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

Verify at the official NPI Registry.