Individual provider Active NPI

Marie Clouqueur

  • Clinical Social Worker
  • Belmont, MA
National Provider Identifier
1366843658
Registry record updated Jun 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
115 Mill St # Ms 234
Belmont, MA 02478-1064
Phone
(617) 855-3190
NPI assigned
Sep 5, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

115 Mill St # Ms 234
Belmont, MA 02478-1064

Mailing address

115 Mill St # Ms 234
Belmont, MA 02478-1064
Phone (617) 855-3190

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
I20220720000179 MA Practitioner - Clinical Social Worker 5890176002 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The McLean Hospital CorporationGroup PAC ID 9436040961, 186 clinicians

Practice addresses (Care Compare)

115 Mill St
Belmont, MA 02478-1064
Phone (617) 855-3450

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The McLean Hospital Corporation Clinical CurrentSince Aug 15, 2022 Accepting new patients

Locations

115 Mill St
#234
Belmont, MA 02478
Phone (617) 855-2305

115 Mill St
Belmont, MA 02478
Phone (617) 855-2000

Interoperability endpoints

  • Direct secure messaging: clouqueur.marie.mcl@direct.partners.masshiway.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1409875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1366843658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 MILL ST # MS 234",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024781064",
            "telephone_number": "617-855-3190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 MILL ST # MS 234",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024781064",
            "telephone_number": "617-855-3190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOUQUEUR",
        "first_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-05",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belmont, MA

Sources for this page

Verify at the official NPI Registry.