Michelle Monica Ennis, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

121527 Issued in MA

Practice address

50 Tower Rd
Plymouth, MA 02360-2038

Phone

(508) 746-8426

NPI assigned

Dec 1, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1245835917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 TOWER RD",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602038",
            "telephone_number": "508-746-8426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 TOWER RD",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602038",
            "telephone_number": "508-746-8426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENNIS",
        "first_name": "MICHELLE",
        "middle_name": "MONICA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-01",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "121527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Plymouth, MA
• Providers in Plymouth, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; 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.