Individual provider Active NPI

Laura Koumarianos, LICSW

  • Clinical Social Worker
  • Danvers, MA
National Provider Identifier
1386123149
Registry record updated Aug 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
113992 Issued in MA
Practice address
16 Toomey St
Danvers, MA 01923-1738
Phone
(978) 539-8544
NPI assigned
Aug 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2018

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 113992 MA Primary

Addresses

Primary practice location

16 Toomey St
Danvers, MA 01923-1738

Mailing address

16 Toomey St
Danvers, MA 01923-1738
Phone (978) 539-8544

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
113992MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1533945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533945600000",
    "number": "1386123149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 TOOMEY ST",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019231738",
            "telephone_number": "978-539-8544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 TOOMEY ST",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019231738",
            "telephone_number": "978-539-8544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUMARIANOS",
        "first_name": "LAURA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-11",
        "last_updated": "2018-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "113992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danvers, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2018; 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.