Individual provider Active NPI

Winston Trefry, LICSW

  • Clinical Social Worker
  • Wilmington, MA
National Provider Identifier
1265478200
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
111599 Issued in MA
Practice address
5 Middlesex Ave
Ste 11, Wilmington Family Counseling Service Inc
Wilmington, MA 01887
Phone
(978) 658-9889
Fax
(978) 658-5695
NPI assigned
Jun 20, 2006
Sex
Male
Sole proprietor
No

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 111599 MA Primary

Addresses

Primary practice location

5 Middlesex Ave
Ste 11, Wilmington Family Counseling Service Inc
Wilmington, MA 01887

Mailing address

587 Essex Street
Beverly, MA 01915
Phone (978) 232-9223

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
I20051209000075 MA Practitioner - Clinical Social Worker 0547281248 Practice locations: Manchester by the Sea, MA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
111599MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Hospital Corporation Past Accepting new patients
Northeast Behavioral Health Corporation Past Accepting new patients
Wilmington Family Counseling Service Inc PastSince Nov 1, 1996 Accepting new patients

Organizations & group practices 3

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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265478200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "587 ESSEX STREET",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "01915",
            "telephone_number": "978-232-9223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MIDDLESEX AVE",
            "address_2": "STE 11, WILMINGTON FAMILY COUNSELING SERVICE INC",
            "city": "WILMINGTON",
            "state": "MA",
            "postal_code": "01887",
            "telephone_number": "978-658-9889",
            "fax_number": "978-658-5695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREFRY",
        "first_name": "WINSTON",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "111599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, MA

Sources for this page

Verify at the official NPI Registry.