Active NPI
Latease Alexis Guilderson, LCSW
- Social Worker
- Hyde Park, MA
National Provider Identifier
1336715481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 226835
- Practice address
- 56 Hamilton St
Hyde Park, MA 02136-2318 - Phone
- (617) 953-4395
- NPI assigned
- May 30, 2021
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 226835 | MA | Primary |
Addresses
Primary practice location
56 Hamilton St
Hyde Park, MA 02136-2318
Mailing address
56 Hamilton St
Hyde Park, MA 02136-2318
Phone (617) 953-4395
Other names 1
- Latease Alexis Adams
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 |
|---|---|---|---|
| 226835 | MA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622332800000",
"number": "1336715481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "56 HAMILTON ST",
"city": "HYDE PARK",
"state": "MA",
"postal_code": "021362318",
"telephone_number": "617-953-4395"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "56 HAMILTON ST",
"city": "HYDE PARK",
"state": "MA",
"postal_code": "021362318",
"telephone_number": "617-953-4395"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUILDERSON",
"first_name": "LATEASE",
"middle_name": "ALEXIS",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-30",
"last_updated": "2021-05-30",
"certification_date": "2021-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MA",
"license": "226835",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LATEASE",
"last_name": "ADAMS",
"middle_name": "ALEXIS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Hyde Park, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.