Individual provider Active NPI

Christine Ann Mirot, MSW

  • Clinical Social Worker
  • Longmeadow, MA
National Provider Identifier
1285833228
Registry record updated Sep 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1026233 Issued in MA
Practice address
175 Dwight Rd Ste 107
Longmeadow, MA 01106-1767
Phone
(413) 627-0763
NPI assigned
Jul 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2016

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 1026233 MA Primary

Addresses

Primary practice location

175 Dwight Rd Ste 107
Longmeadow, MA 01106-1767

Mailing address

175 Dwight Rd Ste 107
Longmeadow, MA 01106-1767
Phone (413) 627-0763

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
I20040202000009 MA Practitioner - Clinical Social Worker 4486557824 Practice locations: Longmeadow, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

175 Dwight Rd
Suite 107
Longmeadow, MA 01106-1767
Phone (413) 627-0763

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1026233MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Inc PastSince Feb 2, 2025 Accepting new patients

Organizations & group practices 1

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": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473292800000",
    "number": "1285833228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 DWIGHT RD STE 107",
            "city": "LONGMEADOW",
            "state": "MA",
            "postal_code": "011061767",
            "telephone_number": "413-627-0763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 DWIGHT RD STE 107",
            "city": "LONGMEADOW",
            "state": "MA",
            "postal_code": "011061767",
            "telephone_number": "413-627-0763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIROT",
        "first_name": "CHRISTINE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-11",
        "last_updated": "2016-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1026233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmeadow, MA

Sources for this page

Verify at the official NPI Registry.