Individual provider Active NPI

Lorna Elizabeth Dimeo, M.S.W., L.I.C.S.W.

  • Clinical Social Worker
  • Andover, MA
National Provider Identifier
1366569188
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
104558 Issued in MA
Practice address
84 N Main St
Andover, MA 01810-3515
Phone
(978) 470-3453
NPI assigned
Mar 25, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 104558 MA Primary
Clinical Social Worker 1041C0700X 20 NH

Addresses

Primary practice location

84 N Main St
Andover, MA 01810-3515

Mailing address

84 N Main St
Andover, MA 01810-3515
Phone (978) 470-3453

Other identifiers 4

IdentifierTypeStateIssuer
104558OtherMALICENSE
20OtherNHLICENSE NUMBER
011623MedicaidMA
PO2690OtherMABLUE CROSS-BLUE SHIELD

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110707000100 MA Practitioner - Clinical Social Worker 9335327774 Practice locations: Andover, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

84 N Main St
Andover, MA 01810-3515

84 N Main St
Andover, MA 01810-3835
Phone (978) 470-3453

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
104558MAMDClinical Social Worker
20NHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1174780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366569188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 N MAIN ST",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018103515",
            "telephone_number": "978-470-3453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 N MAIN ST",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018103515",
            "telephone_number": "978-470-3453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMEO",
        "first_name": "LORNA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "M.S.W., L.I.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "104558",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "20",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "104558",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "20",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "011623",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS-BLUE SHIELD",
            "identifier": "PO2690",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, MA

Sources for this page

Verify at the official NPI Registry.