Individual provider Active NPI

Nancy J Leary, LICSW

  • Clinical Social Worker
  • North Dartmouth, MA
National Provider Identifier
1386823839
Registry record updated Aug 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
115073 Issued in MA
Practice address
106 State Road
North Dartmouth, MA 02747-2923
Phone
(508) 642-2389
Fax
(508) 342-5669
NPI assigned
Nov 1, 2007
Last updated
Aug 6, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 211941 MA
Clinical Social Worker 1041C0700X 115073 MA Primary
School Social Worker 1041S0200X 400530 MA

Addresses

Primary practice location

106 State Road
North Dartmouth, MA 02747-2923

Mailing address

106 State Road
North Dartmouth, MA 02747-2923
Phone (508) 642-2389

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
I20120418000540 MA Practitioner - Clinical Social Worker 9335300391 Practice locations: North Dartmouth, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

106 State Rd
North Dartmouth, MA 02747-2923

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
211941MAMDClinical Social Worker
400530MAMDSchool Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1193875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1386823839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 STATE ROAD",
            "city": "NORTH DARTMOUTH",
            "state": "MA",
            "postal_code": "027472923",
            "telephone_number": "508-642-2389",
            "fax_number": "508-342-5669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 STATE ROAD",
            "city": "NORTH DARTMOUTH",
            "state": "MA",
            "postal_code": "027472923",
            "telephone_number": "508-642-2389",
            "fax_number": "508-342-5669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEARY",
        "first_name": "NANCY",
        "middle_name": "J",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-01",
        "last_updated": "2019-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "211941",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "115073",
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "MA",
            "license": "400530",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Dartmouth, MA

Sources for this page

Verify at the official NPI Registry.