Active NPI
Lawrence Haydu, LICSW
- Clinical Social Worker
- Newton, MA
National Provider Identifier
1356417802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 102558
- Practice address
- 53 Langley Rd
#330
Newton, MA 02459-1913 - Phone
- (617) 332-1201
- Fax
- (978) 443-7791
- NPI assigned
- Nov 27, 2006
- 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 | 102558 | MA | Primary |
Addresses
Primary practice location
53 Langley Rd
#330
Newton, MA 02459-1913
Mailing address
53 Langley Rd
#330
Newton, MA 02459-1913
Phone (617) 332-1201
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P01371 | Other | MA | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 12, 2020 through Jan 12, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 102558 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1356417802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "53 LANGLEY RD",
"address_2": "#330",
"city": "NEWTON",
"state": "MA",
"postal_code": "024591913",
"telephone_number": "617-332-1201",
"fax_number": "978-443-7791"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "53 LANGLEY RD",
"address_2": "#330",
"city": "NEWTON",
"state": "MA",
"postal_code": "024591913",
"telephone_number": "617-332-1201",
"fax_number": "978-443-7791"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYDU",
"first_name": "LAWRENCE",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "102558",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "P01371",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newton, MA
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.