Individual provider Active NPI

Megan Lara Relin, LICSW

  • Clinical Social Worker
  • Amherst, MA
National Provider Identifier
1396930764
Registry record updated Feb 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
116003 Issued in MA
Practice address
401 Main St
Suite 109
Amherst, MA 01002-2368
Phone
(413) 559-1072
NPI assigned
Sep 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2012

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 116003 MA Primary

Addresses

Primary practice location

401 Main St
Suite 109
Amherst, MA 01002-2368

Mailing address

31 Capt Lathrop Dr
South Deerfield, MA 01373-1104
Phone (413) 559-1072

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
116003MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1189382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329264000000",
    "number": "1396930764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 CAPT LATHROP DR",
            "city": "SOUTH DEERFIELD",
            "state": "MA",
            "postal_code": "013731104",
            "telephone_number": "413-559-1072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 MAIN ST",
            "address_2": "SUITE 109",
            "city": "AMHERST",
            "state": "MA",
            "postal_code": "010022368",
            "telephone_number": "413-559-1072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RELIN",
        "first_name": "MEGAN",
        "middle_name": "LARA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-10",
        "last_updated": "2012-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "116003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; 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.