Individual provider Active NPI

Mary Jane Foley, LICSW

  • Clinical Social Worker
  • Southbridge, MA
National Provider Identifier
1245542372
Registry record updated Jul 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
106109 Issued in MA
Practice address
328 Main St
Southbridge, MA 01550-3727
Phone
(508) 765-9101
Fax
(508) 764-4389
NPI assigned
Jul 6, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2010

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 106109 MA Primary

Addresses

Primary practice location

328 Main St
Southbridge, MA 01550-3727

Mailing address

5 Shary LN
Auburn, MA 01501-3316
Phone (508) 765-9102

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: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1983
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

108 Grove St
Worcester, MA 01605-2629

26 Tower PL
Fanwood, NJ 07023-1023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
106109MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Revidas LLC Past Accepting new patients

Organizations & group practices 1

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": "1278374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278374400000",
    "number": "1245542372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 SHARY LN",
            "city": "AUBURN",
            "state": "MA",
            "postal_code": "015013316",
            "telephone_number": "508-765-9102",
            "fax_number": "508-764-4389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "328 MAIN ST",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "015503727",
            "telephone_number": "508-765-9101",
            "fax_number": "508-764-4389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOLEY",
        "first_name": "MARY JANE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-06",
        "last_updated": "2010-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "106109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southbridge, MA

Sources for this page

Verify at the official NPI Registry.