Individual provider Active NPI

Judith Ellman, LICSW

  • Clinical Social Worker
  • Jamaica Plain, MA
National Provider Identifier
1336489574
Registry record updated Feb 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
116158 Issued in MA
Practice address
157 Green St
Jamaica Plain, MA 02130-2667
Phone
(617) 524-1120
NPI assigned
Feb 25, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2013

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 116158 MA Primary

Addresses

Primary practice location

157 Green St
Jamaica Plain, MA 02130-2667

Mailing address

254 Amory St # 2
Jamaica Plain, MA 02130-2310
Phone (617) 458-9828

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210128001763 MA Practitioner - Clinical Social Worker 5991119133 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Arbour IncGroup PAC ID 6800975574, 19 clinicians

Practice addresses (Care Compare)

157 Green St
Jamaica Plain, MA 02130-2667
Phone (617) 390-1362

49 Robinwood Ave
Boston, MA 02130-2156
Phone (617) 522-4400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Arbour Inc CurrentSince Nov 16, 2020 Accepting new patients
Arbour Inc CurrentSince Nov 16, 2020 Accepting new patients

Locations

157 Green St
Jamaica Plain, MA 02130
Phone (617) 524-1120

49 Robinwood Ave
Jamaica Plain, MA 02130
Phone (617) 390-1204

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1361750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361750400000",
    "number": "1336489574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 AMORY ST # 2",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021302310",
            "telephone_number": "617-458-9828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 GREEN ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021302667",
            "telephone_number": "617-524-1120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLMAN",
        "first_name": "JUDITH",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-25",
        "last_updated": "2013-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "116158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica Plain, MA

Sources for this page

Verify at the official NPI Registry.