Individual provider Active NPI

Mary Alice Lacy Pardee, MSW LICSW

  • Clinical Social Worker
  • Gloucester, MA
National Provider Identifier
1376531525
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1019358 Issued in MA
Practice address
85 Eastern Ave
Suite 204
Gloucester, MA 01930-1869
Phone
(978) 282-1136
Fax
(978) 282-1144
NPI assigned
Oct 12, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 1019358 MA Primary

Addresses

Primary practice location

85 Eastern Ave
Suite 204
Gloucester, MA 01930-1869

Mailing address

85 Eastern Ave
Suite 204
Gloucester, MA 01930-1869
Phone (978) 282-1136

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
I20051107000982 MA Practitioner - Clinical Social Worker 1658399712 Practice locations: Rockport, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4 Pasture Rd
Rockport, MA 01966-1348
Phone (978) 546-6032

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Neil Kobrosky MD Past Accepting new patients

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": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1376531525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 EASTERN AVE",
            "address_2": "SUITE 204",
            "city": "GLOUCESTER",
            "state": "MA",
            "postal_code": "019301869",
            "telephone_number": "978-282-1136",
            "fax_number": "978-282-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 EASTERN AVE",
            "address_2": "SUITE 204",
            "city": "GLOUCESTER",
            "state": "MA",
            "postal_code": "019301869",
            "telephone_number": "978-282-1136",
            "fax_number": "978-282-1144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARDEE",
        "first_name": "MARY ALICE",
        "middle_name": "LACY",
        "name_prefix": "Ms.",
        "credential": "MSW LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1019358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gloucester, MA

Sources for this page

Verify at the official NPI Registry.