Active NPI
Premela G. Deck, LCSW
- Social Worker
- Canton, MA
National Provider Identifier
1306461272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 224625
- Practice address
- 789 Washington St
Canton, MA 02021-3021 - Phone
- (781) 828-7660
- Fax
- (781) 712-1234
- NPI assigned
- Jun 16, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 224625 | MA | Primary |
Addresses
Primary practice location
789 Washington St
Canton, MA 02021-3021
Mailing address
789 Washington St
Canton, MA 02021-3021
Phone (781) 828-7660
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 224625 | MA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592265600000",
"number": "1306461272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "789 WASHINGTON ST",
"city": "CANTON",
"state": "MA",
"postal_code": "020213021",
"telephone_number": "781-828-7660",
"fax_number": "781-712-1234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "789 WASHINGTON ST",
"city": "CANTON",
"state": "MA",
"postal_code": "020213021",
"telephone_number": "781-828-7660",
"fax_number": "781-712-1234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DECK",
"first_name": "PREMELA",
"middle_name": "G.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-16",
"last_updated": "2020-06-16",
"certification_date": "2020-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MA",
"license": "224625",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.