Individual provider Active NPI

Misty Pisani

  • Clinical Social Worker
  • Randolph, MA
National Provider Identifier
1326554064
Registry record updated Dec 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
119471 Issued in MA
Practice address
47 Collins Ave
Randolph, MA 02368-2003
Phone
(781) 964-1377
NPI assigned
Dec 18, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2017

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 119471 MA Primary

Addresses

Primary practice location

47 Collins Ave
Randolph, MA 02368-2003

Mailing address

47 Collins Ave
Randolph, MA 02368-2003
Phone (781) 964-1377

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

LicenseStateTypeSpecialty
119471MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1513555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513555200000",
    "number": "1326554064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 COLLINS AVE",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023682003",
            "telephone_number": "781-964-1377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 COLLINS AVE",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023682003",
            "telephone_number": "781-964-1377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PISANI",
        "first_name": "MISTY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-18",
        "last_updated": "2017-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "119471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randolph, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2017; 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.