Individual provider Active NPI

Martha Otterbeck, LICSW

  • Clinical Social Worker
  • Westfield, MA
National Provider Identifier
1255418489
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1027480 Issued in MA
Practice address
45 Broad St
Westfield, MA 01085-2956
Phone
(413) 667-5376
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1027480 MA Primary

Addresses

Primary practice location

45 Broad St
Westfield, MA 01085-2956

Mailing address

45 Broad St
Westfield, MA 01085-2956
Phone (413) 667-5376

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051022000072 MA Practitioner - Clinical Social Worker 3678599248 Practice locations: Westfield, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

45 Broad St
Westfield, MA 01085-2956
Phone (413) 568-9858

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1027480MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Say Peas Speech and Feeding Therapy 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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255418489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 BROAD ST",
            "city": "WESTFIELD",
            "state": "MA",
            "postal_code": "010852956",
            "telephone_number": "413-667-5376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 BROAD ST",
            "city": "WESTFIELD",
            "state": "MA",
            "postal_code": "010852956",
            "telephone_number": "413-667-5376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTERBECK",
        "first_name": "MARTHA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1027480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westfield, MA

Sources for this page

Verify at the official NPI Registry.