Miriam Louise Ross, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

100996 Issued in MA

Practice address

15 Vincent St
West Newton, MA 02465-1915

Phone

(617) 964-3676

NPI assigned

Dec 26, 2008

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

Other names 1

• Ms. Mimi Louise Ross Professional name

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.

• Colony Care Inc

  • Mental Health Counselor
  • Wellesley, MA
  • NPI 1720053408
  NPD (past)

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

{
    "created_epoch": "1230249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230249600000",
    "number": "1265678148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 VINCENT ST",
            "city": "WEST NEWTON",
            "state": "MA",
            "postal_code": "024651915",
            "telephone_number": "617-964-3676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 VINCENT ST",
            "city": "WEST NEWTON",
            "state": "MA",
            "postal_code": "024651915",
            "telephone_number": "617-964-3676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "MIRIAM",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-26",
        "last_updated": "2008-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "100996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIMI",
            "last_name": "ROSS",
            "middle_name": "LOUISE",
            "prefix": "MS.",
            "credential": "LICSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Redwood Acquisition West LLC
• Peter Rider, DMD
• Amanda Rose Rodrigues, ATC
• Dan H Rome, M.D.
• Michelle L Roover, LICSW, MS
• Dominique D. Rousson, D.M.D.
• Rhonda Natanblut Ruby, M.S.
• Sarah Horn, Licsw
• Diane Sartanowicz, ATC, LAT
• Scandinavian Charitable Society of Greater Boston

• Clinical Social Worker in West Newton, MA
• Providers in West Newton, 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 26, 2008; 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.