Individual provider Active NPI

Miriam Pugh, LICSW

  • Clinical Social Worker
  • Roslindale, MA
National Provider Identifier
1427539337
Registry record updated Aug 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
117278-SW-LICSW Issued in MA
Practice address
66 Bateman St
Roslindale, MA 02131-4924
Phone
(617) 851-1159
NPI assigned
Aug 28, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2018

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 117278-SW-LICSW MA Primary

Addresses

Primary practice location

66 Bateman St
Roslindale, MA 02131-4924

Mailing address

66 Bateman St
Roslindale, MA 02131-4924

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
117278-SW-LICSWMAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1535414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1427539337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 BATEMAN ST",
            "city": "ROSLINDALE",
            "state": "MA",
            "postal_code": "021314924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 BATEMAN ST",
            "city": "ROSLINDALE",
            "state": "MA",
            "postal_code": "021314924",
            "telephone_number": "617-851-1159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUGH",
        "first_name": "MIRIAM",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-28",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "117278-SW-LICSW",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslindale, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2018; 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.