Individual provider Active NPI

Marieca Cathryn Davieau, MSW, LICSW, CCM

  • Clinical Social Worker
  • Worcester, MA
National Provider Identifier
1245734573
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1029379 Issued in MA
Practice address
50 Prescott St Ste 3300
Worcester, MA 01605-2652
Phone
(508) 890-6400
Fax
(508) 890-6410
NPI assigned
Mar 21, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 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 1029379 MA Primary

Addresses

Primary practice location

50 Prescott St Ste 3300
Worcester, MA 01605-2652

Mailing address

4 Hartshorn Ave Apt 1
Worcester, MA 01602-2904
Phone (508) 890-6407

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
1029379MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1245734573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 HARTSHORN AVE APT 1",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016022904",
            "telephone_number": "508-890-6407",
            "fax_number": "508-890-6410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 PRESCOTT ST STE 3300",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052652",
            "telephone_number": "508-890-6400",
            "fax_number": "508-890-6410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIEAU",
        "first_name": "MARIECA",
        "middle_name": "CATHRYN",
        "credential": "MSW, LICSW, CCM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-21",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1029379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.