Miriam Novogrodsky, LICSW
Individual provider Active NPI Clinical Social Worker · Ipswich, MA
NPI 1295841526 · NPPES record last updated Nov 21, 2016
Key facts
- NPI
- 1295841526
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 112044 (MA)
- Practice address
- 21 Market St
Ipswich, MA 01938-2240 - Phone
- (413) 592-1980
- NPI assigned
- Aug 21, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 112044 | MA | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 112044 | MA | Yes |
Addresses
Primary practice location
21 Market St
Ipswich, MA 01938-2240
Mailing address
10 Kinsman CT
Ipswich, MA 01938-2315
Phone (978) 356-3397
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00332648 | Other | MA | RAILROAD MEDICARE |
Other providers in Ipswich, MA
- Sean Moynihan
- Colleen Mulkerin
- Deborah Christine Nelson
- Noble Solutions Corp
- North Shore Healing Hub
- Karen O'Lalor
- Meagan O'Neill
- Swiatoslaw Alexander Paduchak
- Sejal Mahesh Patel
- Ashely Rose Perkins
All providers in Ipswich, 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 Nov 21, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.