Ana Luiza Archibald, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

117796 Issued in MA

Practice address

160 State St FL 3
Boston, MA 02109-2540

Phone

(617) 410-4902

NPI assigned

Jun 12, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ana Luiza Brenner Mascagni Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528761600000",
    "number": "1356834584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 GOLDSMITH ST # 1",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021303121",
            "telephone_number": "617-413-5898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 STATE ST FL 3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021092540",
            "telephone_number": "617-410-4902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCHIBALD",
        "first_name": "ANA",
        "middle_name": "LUIZA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-12",
        "last_updated": "2018-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "117796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANA",
            "last_name": "BRENNER MASCAGNI",
            "middle_name": "LUIZA",
            "credential": "LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Simon David Archambault, MS
• Gemma Archer
• John Matthew Archer, M.D.
• Natasha Marie Bernadette Archer, MD
• Sonia Y Archer, M.D.
• Jennifer Joanna Archibald, DDS
• John Archibald, LICSW
• Brittany Archie
• Chinyere Archie, MD
• Lisa M. Arcikowski, NP

• Clinical Social Worker in Boston, MA
• Providers in 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 Jun 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.