NPIMap

Individual provider Active NPI

Tamara Leroy-London, LICSW

  • Clinical Social Worker
  • Dorchester, MA
National Provider Identifier
1427409465
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
121982 Issued in MA
Practice address
637 Washington St
Dorchester, MA 02124-3510
Phone
(617) 825-9660
Fax
(617) 288-7898
NPI assigned
Jun 30, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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 121982 MA Primary

Addresses

Primary practice location

637 Washington St
Dorchester, MA 02124-3510

Mailing address

637 Washington St
Dorchester, MA 02124-3510
Phone (617) 825-9660

Other practice location 1

4238 Washington St Ste 311
Roslindale, MA 02131-2558
Phone (617) 297-8832

Other identifiers 1

IdentifierTypeStateIssuer
110152007AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190923001069 MA Practitioner - Clinical Social Worker 9739419599 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Codman Square Health Center, IncGroup PAC ID 8123013869, 67 clinicians

Practice addresses (Care Compare)

637 Washington St
Dorchester, MA 02124-3510
Phone (617) 825-9660

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
121982MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Codman Square Health Center Inc CurrentSince Sep 1, 2019 Accepting new patients
Boston Medical Center Corporation Current Accepting new patients
Healing With Trust Therapy, LLC Current Accepting new patients

Locations

637 Washington St
Dorchestr Ctr, MA 02124
Phone (617) 822-8211

Interoperability endpoints

  • Direct secure messaging: tleroylondon181627@direct.bmc.masshiway.net

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 and National Provider Directory roles.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1427409465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "637 WASHINGTON ST",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021243510",
            "telephone_number": "617-825-9660",
            "fax_number": "617-288-7898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "637 WASHINGTON ST",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021243510",
            "telephone_number": "617-825-9660",
            "fax_number": "617-288-7898"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4238 Washington St Ste 311",
            "address_purpose": "LOCATION",
            "city": "Roslindale",
            "state": "MA",
            "postal_code": "021312558",
            "country_code": "US",
            "telephone_number": "617-297-8832",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEROY-LONDON",
        "first_name": "TAMARA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-30",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "121982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110152007A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester, MA

Sources for this page

Verify at the official NPI Registry.