Active NPI
Matthew A Aversa, MSW
- Clinical Social Worker
- Manchester, NH
National Provider Identifier
1346445715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1047
- Practice address
- 718 Smyth Rd
Manchester, NH 03104-7004 - Phone
- (603) 624-4366
- NPI assigned
- Jun 18, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 1047 | NH | Primary |
Addresses
Primary practice location
718 Smyth Rd
Manchester, NH 03104-7004
Mailing address
54 Coolidge Dr
Washington, NH 03280-3471
Phone (603) 495-0489
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1047 | NH | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| NH Catholic Charities Inc | Clinical | Past | 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.
-
- Clinical Social Worker
- Manchester, NH
- NPI 1255417408
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1346445715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "54 COOLIDGE DR",
"city": "WASHINGTON",
"state": "NH",
"postal_code": "032803471",
"telephone_number": "603-495-0489"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "718 SMYTH RD",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "031047004",
"telephone_number": "603-624-4366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVERSA",
"first_name": "MATTHEW",
"middle_name": "A",
"name_prefix": "Mr.",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NH",
"license": "1047",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manchester, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.