Andrew Jake Devellis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

123328 Issued in MA

Practice address

1 Frederick Abbott Way
Framingham, MA 01701-7992

Phone

(508) 270-1379

Fax

(508) 875-1348

NPI assigned

Sep 9, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Wayside Youth and Family Support Network

  • Mental Health Counselor
  • Framingham, MA
  • NPI 1851484505
  NPD (past)

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

{
    "created_epoch": "1441756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1255709176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FREDERICK ABBOTT WAY",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017017992",
            "telephone_number": "508-270-1379",
            "fax_number": "508-875-1348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 FREDERICK ABBOTT WAY",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017017992",
            "telephone_number": "508-270-1379",
            "fax_number": "508-875-1348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVELLIS",
        "first_name": "ANDREW",
        "middle_name": "JAKE",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-09",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "000221897",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "123328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Desio, MD
• Stacy Lynn Desnoyers
• Rafaela Desouza
• Kayla Desrosiers
• Catherine Marie Devaney, M.A.
• Belle Devereaux
• Emily Devergilio
• Colin Burton Devonshire, M.D.
• Courtney Dewey
• Dia Feliz Adhc LLC

• Clinical Social Worker in Framingham, MA
• Providers in Framingham, 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 Mar 20, 2025; 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.