Individual provider Active NPI

Vilmary Lopez, LICSW

  • Clinical Social Worker
  • Worcester, MA
National Provider Identifier
1407226947
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
000123169 Issued in MA
Practice address
81 Plantation St
Worcester, MA 01604-3069
Phone
(508) 849-5600
NPI assigned
Sep 27, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Clinical Social Worker 1041C0700X 000123169 MA Primary

Addresses

Primary practice location

81 Plantation St
Worcester, MA 01604-3069

Mailing address

81 Plantation St
Worcester, MA 01604-3069
Phone (508) 552-7783

Other practice location 1

83 Hospital Rd
Baldwinville, MA 01436-1215
Phone (978) 939-1360

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
I20201223000526 MA Practitioner - Clinical Social Worker 8527470137 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Youth Opportunities Upheld IncGroup PAC ID 9638190374, 15 clinicians

Practice addresses (Care Compare)

135 Gold Star Blvd
Worcester, MA 01606-2738
Phone (508) 459-6400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000123169MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Youth Opportunities Upheld, Inc. CurrentSince Nov 2, 2020 Accepting new patients

Locations

81 Plantation St
Worcester, MA 01604
Phone (508) 890-6519

135 Gold Star Blvd
Worcester, MA 01606
Phone (508) 459-6400

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/youinc/r4/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1443312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1407226947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 PLANTATION ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016043069",
            "telephone_number": "508-552-7783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 PLANTATION ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016043069",
            "telephone_number": "508-849-5600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "83 Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "Baldwinville",
            "state": "MA",
            "postal_code": "014361215",
            "country_code": "US",
            "telephone_number": "978-939-1360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "VILMARY",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-27",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "000123169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.