Individual provider Active NPI

Sheila Diane Tamkin Simons, LICSW

  • Clinical Social Worker
  • West Roxbury, MA
National Provider Identifier
1316241490
Registry record updated Jan 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
113971 Issued in MA
Practice address
56 Westover St
Suite a
West Roxbury, MA 02132-1342
Phone
(339) 206-3974
NPI assigned
Jan 4, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2011

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 113971 MA Primary

Addresses

Primary practice location

56 Westover St
Suite a
West Roxbury, MA 02132-1342

Mailing address

35 Crest Rd
Sharon, MA 02067-1442
Phone (339) 206-3974

Other identifiers 2

IdentifierTypeStateIssuer
9164196OtherMAAETNA
7121168OtherMACIGNA

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
113971MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1294099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294099200000",
    "number": "1316241490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 CREST RD",
            "city": "SHARON",
            "state": "MA",
            "postal_code": "020671442",
            "telephone_number": "339-206-3974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 WESTOVER ST",
            "address_2": "SUITE A",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021321342",
            "telephone_number": "339-206-3974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMKIN SIMONS",
        "first_name": "SHEILA",
        "middle_name": "DIANE",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-04",
        "last_updated": "2011-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "113971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9164196",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7121168",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Roxbury, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.