Nancy Metra Brooks, L.I.C.S.W.
Individual provider Active NPI Clinical Social Worker · Gardner, MA
NPI 1295024511 · NPPES record last updated Apr 7, 2011
Key facts
- NPI
- 1295024511
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 110449 (MA)
- Practice address
- 116 Stone St
Gardner, MA 01440-1142 - Phone
- (978) 630-4775
- NPI assigned
- Apr 7, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Stacey Nicholas LLC
Practice addresses (Care Compare)
285 E Main St
Somerville, NJ 08876-3005
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MA, NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130305000447 | MA | Practitioner - Clinical Social Worker | 7719132398 | Reassigns benefits to 1 organization |
| I20201103000853 | NJ | Practitioner - Clinical Social Worker | 7719132398 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 110449 | MA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stacey Nicholas LLC | Clinical | Current |
Accepting new patients |
| Heywood Medical Group Inc. | Current |
Accepting new patients | |
| Mind Over Matter, LLC | Past | Accepting new patients |
Locations
250 Green St
Gardner, MA 01440
Phone (978) 630-5050
242 Green St
Gardner, MA 01440
Phone (978) 258-4734
285 E Main St
Somerville, NJ 08876
Phone (908) 295-2007
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 110449 | MA | Yes |
Addresses
Primary practice location
116 Stone St
Gardner, MA 01440-1142
Mailing address
116 Stone St
Gardner, MA 01440-1142
Phone (978) 630-4775
Other providers in Gardner, MA
- Kirsten Marie Bright
- Brightleaf Behavioral Support
- Karen Jay Brocksmith
- Chrystal Brogna
- Mark Lawrence Brooks
- Nicolle Brooks
- Rachael Brow
- Robert W Brown
- Kelly Butler
- Mary Cadahia
All providers in Gardner, MA · Clinical Social Worker in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 7, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.