Audrey Rogovin Wood, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

000226125 Issued in MA

Practice address

19 Elm St
Maynard, MA 01754-2628

Phone

(978) 844-2717

NPI assigned

Apr 9, 2021

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 identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Boston Child Study Center Psychology Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Los Angeles, CA
  • NPI 1972239242
  NPD
• Boston Child Study Center Los Angeles Licensed Clinical Social Work SE

  • Psychologist
  • Los Angeles, CA
  • NPI 1992273338
  NPD (past)

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

{
    "created_epoch": "1617926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1366022873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 BOYLSTON ST FL 5",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021162639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 ELM ST",
            "city": "MAYNARD",
            "state": "MA",
            "postal_code": "017542628",
            "telephone_number": "978-844-2717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "AUDREY",
        "middle_name": "ROGOVIN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-09",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "000226125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL WORK LICENSE",
            "identifier": "000226125",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "awood@bostonchildstudycenter.com",
            "affiliation": "N",
            "address_1": "19 Elm St",
            "city": "Maynard",
            "state": "MA",
            "country_code": "US",
            "postal_code": "017542628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Keith Douglas Warren
• Taylor Welch
• Patricia White, OTR/L
• Jacqueline Wibert
• Sarah Patten Wilder, R.D., LDN, CEDRD
• Wright Counseling Practice LLC
• Priscilla Wright, MSW, LCSW

• Clinical Social Worker in Maynard, MA
• Providers in Maynard, 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 Apr 9, 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.

Verify at the official NPI Registry.