NPIMap

Organization Active NPI

Walpole Behavioral Healthcare, LLC

  • Clinical Social Worker
  • Walpole, MA
National Provider Identifier
1326590332
Registry record updated Oct 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
114117 Issued in MA
Legal business name
WALPOLE BEHAVIORAL HEALTHCARE, LLC
Practice address
841 Main St
LL2
Walpole, MA 02081-2997
Phone
(508) 660-6699
Fax
(508) 660-6658
NPI assigned
Oct 26, 2016
Last updated
Oct 26, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2016

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

Authorized official

Name
Mr. James G Farnham, LICSWNPI 1386662997
Title
Owner
Phone
(508) 660-6699

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 114117 MA Primary

Addresses

Primary practice location

841 Main St
LL2
Walpole, MA 02081-2997

Mailing address

841 Main St
LL2
Walpole, MA 02081-2997
Phone (508) 660-6699

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170411000270 MA Part B Supplier - Clinic/Group Practice 2062798887 Receives reassigned benefits from 5 practitioners
Practice locations: Walpole, MA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1477440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477440000000",
    "number": "1326590332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 MAIN ST",
            "address_2": "LL2",
            "city": "WALPOLE",
            "state": "MA",
            "postal_code": "020812997",
            "telephone_number": "508-660-6699",
            "fax_number": "508-660-6658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 MAIN ST",
            "address_2": "LL2",
            "city": "WALPOLE",
            "state": "MA",
            "postal_code": "020812997",
            "telephone_number": "508-660-6699",
            "fax_number": "508-660-6658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALPOLE BEHAVIORAL HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-26",
        "last_updated": "2016-10-26",
        "status": "A",
        "authorized_official_last_name": "FARNHAM",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-660-6699",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "114117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walpole, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.