Individual provider Active NPI

Ada Gabriela Avila, LCSW

  • Clinical Social Worker
  • Chelsea, MA
National Provider Identifier
1417507328
Registry record updated Sep 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
000225078 Issued in MA
Practice address
151 Everett Ave
Chelsea, MA 02150-1812
Phone
(617) 606-0196
NPI assigned
Sep 13, 2019
Last updated
Sep 13, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2019

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 000225078 MA Primary

Addresses

Primary practice location

151 Everett Ave
Chelsea, MA 02150-1812

Mailing address

92 Addison St
Chelsea, MA 02150-1929
Phone (617) 606-0196

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
I20230726002015 MA Practitioner - Clinical Social Worker 5294196093 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000225078MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Jun 13, 2023 Accepting new patients
Mind and Heart Workshop Group LLC Clinical Current Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Jun 13, 2023 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

1 Constitution Plz
Ste 140
Charlestown, MA 02129
Phone (617) 724-5202

151 Everett Ave
Chelsea, MA 02150
Phone (617) 884-8300

Organizations & group practices 3

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": "1568332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568332800000",
    "number": "1417507328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 ADDISON ST",
            "city": "CHELSEA",
            "state": "MA",
            "postal_code": "021501929",
            "telephone_number": "617-606-0196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 EVERETT AVE",
            "city": "CHELSEA",
            "state": "MA",
            "postal_code": "021501812",
            "telephone_number": "617-606-0196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILA",
        "first_name": "ADA",
        "middle_name": "GABRIELA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-13",
        "last_updated": "2019-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "000225078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chelsea, MA

Sources for this page

Verify at the official NPI Registry.