Keith Howard Mantel, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

117738 Issued in MA

Practice address

409 W Broadway
South Boston, MA 02127-2245

Phone

(617) 269-7500

NPI assigned

Aug 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Child and Family Psychological Services PLLCGroup PAC ID 5991763823, 260 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Child and Family Psychological Services, PLLC

  dba LifeStance Health

  • Psychologist
  • Norwood, MA
  • NPI 1912987181

  Clinical

  Medicare reassignment Care Compare group NPD
• South Boston Community Health Center

  • Community Health Clinic/Center
  • South Boston, MA
  • NPI 1669447413
  Medicare reassignment NPD

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541462400000",
    "number": "1356351118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 W BROADWAY",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "021272245",
            "telephone_number": "617-269-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 W BROADWAY",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "021272245",
            "telephone_number": "617-269-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTEL",
        "first_name": "KEITH",
        "middle_name": "HOWARD",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2018-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "117738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Macgillivray
• Thomas Edward Magnan, LADCI
• Carolyn Mahler
• Lianna W Malawski
• Carol Malinowski
• Marian Manor, for the Aged and Infirm, Inc. (Marian Manor)
• Hadas Y Maroun
• Alison Marshall, NP
• Emily Elizabeth Martin, PTA
• Jennifer Anne Masello, MS, RD, LDN

• Clinical Social Worker in South Boston, MA
• Providers in South Boston, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.