Active NPI
Alicia Rahema Mooltrey
- Clinical Social Worker
- Jamaica Plain, MA
National Provider Identifier
1326358490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 390200000X
- Practice address
- 161 S Huntington Ave
Jamaica Plain, MA 02130-4885 - Phone
- (617) 264-5382
- Fax
- (617) 232-7925
- NPI assigned
- Oct 7, 2010
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 390200000X | MA | Primary |
Addresses
Primary practice location
161 S Huntington Ave
Jamaica Plain, MA 02130-4885
Mailing address
161 S Huntington Ave
Jamaica Plain, MA 02130-4885
Phone (617) 264-5382
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 |
|---|---|---|---|
| 390200000X | MA | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Radical Joy Inc | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Adult Mental Health Clinic/Center
- Dorchester, MA
- NPI 1679469712
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1286409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1286409600000",
"number": "1326358490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "161 S HUNTINGTON AVE",
"city": "JAMAICA PLAIN",
"state": "MA",
"postal_code": "021304885",
"telephone_number": "617-264-5382",
"fax_number": "617-232-7925"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "161 S HUNTINGTON AVE",
"city": "JAMAICA PLAIN",
"state": "MA",
"postal_code": "021304885",
"telephone_number": "617-264-5382",
"fax_number": "617-232-7925"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOOLTREY",
"first_name": "ALICIA",
"middle_name": "RAHEMA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-07",
"last_updated": "2010-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "390200000X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jamaica Plain, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.