Ellen Kosse Waters, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

102972 Issued in MA

Practice address

257 Ayer Road
Harvard, MA 01451

Phone

(978) 772-4457

Fax

(978) 772-7107

NPI assigned

Sep 21, 2006

Last updated

Nov 14, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321228800000",
    "number": "1306945225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 AYER RD",
            "city": "HARVARD",
            "state": "MA",
            "postal_code": "014511108",
            "telephone_number": "978-772-4457",
            "fax_number": "978-772-7107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "257 AYER ROAD",
            "city": "HARVARD",
            "state": "MA",
            "postal_code": "01451",
            "telephone_number": "978-772-4457",
            "fax_number": "978-772-7107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "ELLEN",
        "middle_name": "KOSSE",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2011-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "102972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nancy Young

• Clinical Social Worker in Harvard, MA
• Providers in Harvard, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.