Individual provider Active NPI

Andrea L Lynch

  • Social Worker
  • Lenox, MA
National Provider Identifier
1376192179
Registry record updated Sep 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
111701-SW-LICSW Issued in MA
Practice address
51 Taconic Ave
Lenox, MA 01240-2348
Phone
(413) 637-1300
Fax
(866) 230-7304
NPI assigned
Sep 5, 2019
Last updated
Sep 5, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 111701-SW-LICSW MA Primary

Addresses

Primary practice location

51 Taconic Ave
Lenox, MA 01240-2348

Mailing address

51 Taconic Ave
Lenox, MA 01240-2348
Phone (413) 637-1300

Other identifiers 1

IdentifierTypeStateIssuer
111701-SW-LICSWOtherMADEPT OF PROFESSIONAL LICENSURE

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL jefaac@aol.com

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
I20221101002594 MA Practitioner - Clinical Social Worker 3870960024 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthdrive Behavioral Health Services, PLLCGroup PAC ID 8729345822, 89 clinicians

Practice addresses (Care Compare)

100 Crossing Blvd
Suite 300
Framingham, MA 01702-5555
Phone (888) 964-6681

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
111701-SW-LICSWMAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Healthdrive Behavioral Health Services, PLLC Single Specialty CurrentSince Jul 18, 2022 Accepting new patients

Locations

100 Crossing Blvd
Ste 300
Framingham, MA 01702
Phone (857) 255-0486

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1567641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1376192179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 TACONIC AVE",
            "city": "LENOX",
            "state": "MA",
            "postal_code": "012402348",
            "telephone_number": "413-637-1300",
            "fax_number": "866-230-7304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 TACONIC AVE",
            "city": "LENOX",
            "state": "MA",
            "postal_code": "012402348",
            "telephone_number": "413-637-1300",
            "fax_number": "866-230-7304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNCH",
        "first_name": "ANDREA",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-05",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "111701-SW-LICSW",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF PROFESSIONAL LICENSURE",
            "identifier": "111701-SW-LICSW",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "jefaac@aol.com",
            "affiliation": "N",
            "address_1": "51 Taconic Ave",
            "city": "Lenox",
            "state": "MA",
            "country_code": "US",
            "postal_code": "012402348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lenox, MA

Sources for this page

Verify at the official NPI Registry.