Deborah A Mongeon, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1032076 Issued in MA

Practice address

105 Pine St
Suite 1
Waltham, MA 02453-5355

Phone

(781) 893-2462

NPI assigned

Aug 20, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Bay State Counseling Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brockton, MA
  • NPI 1386923720
  NPD (past)

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417651200000",
    "number": "1437264249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 JEFFERSON PL",
            "city": "BELLINGHAM",
            "state": "MA",
            "postal_code": "020196301",
            "telephone_number": "508-657-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 PINE ST",
            "address_2": "SUITE 1",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024535355",
            "telephone_number": "781-893-2462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONGEON",
        "first_name": "DEBORAH",
        "middle_name": "A",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2014-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1032076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ahmed Mohiuddin, M.D.
• Leah Moisan
• Kathleen Molgaard, DMD
• Angela Maribel Molina, M.ED
• Sarah Flaherty Monahan, OTR/L
• Marquetta Monroe, LMHC
• Rita M Montes, NP
• Moody Street Total Health, Inc.
• Cindy Moon, DMD
• Keira Moore, M.S., BCBA

• Clinical Social Worker in Waltham, MA
• Providers in Waltham, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2014; 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.