Individual provider Active NPI

Caroline Mary Corrigan, LICSW, CADC

  • Clinical Social Worker
  • Hyannis, MA
National Provider Identifier
1265954614
Registry record updated Oct 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
122852 Issued in MA
Practice address
17 Daria Dr
Hyannis, MA 02601-4464
Phone
(508) 360-0611
NPI assigned
Jul 7, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1842AD MA
Clinical Social Worker 1041C0700X
Clinical Social Worker 1041C0700X 122852 MA Primary

Addresses

Primary practice location

17 Daria Dr
Hyannis, MA 02601-4464

Mailing address

17 Daria Dr
Hyannis, MA 02601-4464
Phone (508) 360-0611

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
I20210427001122 MA Practitioner - Clinical Social Worker 6103234497 Practice locations: Hyannis, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

17 Daria Dr
Hyannis, MA 02601-4464
Phone (508) 360-0611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1842ADMAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1499385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633910400000",
    "number": "1265954614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 DARIA DR",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026014464",
            "telephone_number": "508-360-0611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 DARIA DR",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026014464",
            "telephone_number": "508-360-0611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORRIGAN",
        "first_name": "CAROLINE",
        "middle_name": "MARY",
        "credential": "LICSW, CADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-07",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "1842AD",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "122852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyannis, MA

Sources for this page

Verify at the official NPI Registry.