Individual provider Active NPI

Anna T Micci, LICSW

  • Clinical Social Worker
  • Norwell, MA
National Provider Identifier
1275618894
Registry record updated Dec 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
106420 Issued in MA
Practice address
80 Washington St
Ste O53
Norwell, MA 02061-1747
Phone
(781) 982-9790
NPI assigned
Oct 25, 2006
Last updated
Dec 9, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2019

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 106420 MA Primary

Addresses

Primary practice location

80 Washington St
Ste O53
Norwell, MA 02061-1747

Mailing address

135 Webster St
Hanover, MA 02339
Phone (781) 982-9790

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
I20051011000560 MA Practitioner - Clinical Social Worker 3870518665 Practice locations: Cohasset, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Cohasset, MA 02025
Phone (781) 405-4857

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
106420MAMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575849600000",
    "number": "1275618894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 WEBSTER ST",
            "city": "HANOVER",
            "state": "MA",
            "postal_code": "02339",
            "telephone_number": "781-982-9790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 WASHINGTON ST",
            "address_2": "STE O53",
            "city": "NORWELL",
            "state": "MA",
            "postal_code": "020611747",
            "telephone_number": "781-982-9790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICCI",
        "first_name": "ANNA",
        "middle_name": "T",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "106420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwell, MA

Sources for this page

Verify at the official NPI Registry.