Active NPI
Kristen Lee Costa, LICSW
- Clinical Social Worker
- Middleboro, MA
National Provider Identifier
1437298940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 112239
- Practice address
- 511 W Grove St
Suite 105
Middleboro, MA 02346-1458 - Phone
- (508) 923-3427
- Fax
- (508) 923-3428
- NPI assigned
- Feb 5, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 112239 | MA | Primary |
Addresses
Primary practice location
511 W Grove St
Suite 105
Middleboro, MA 02346-1458
Mailing address
511 W Grove St
Suite 105
Middleboro, MA 02346-1458
Phone (508) 923-3427
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7009847 | Other | MA | AETNA |
| 494574 | Other | MA | TUFTS |
| PO8602 | Other | MA | BLUE CROSS |
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Edgardo C. Angeles, MD & Associates, PC | Clinical | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Counselor
- Middleboro, MA
- NPI 1144332115
Clinical
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1437298940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "511 W GROVE ST",
"address_2": "SUITE 105",
"city": "MIDDLEBORO",
"state": "MA",
"postal_code": "023461458",
"telephone_number": "508-923-3427",
"fax_number": "508-923-3428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "511 W GROVE ST",
"address_2": "SUITE 105",
"city": "MIDDLEBORO",
"state": "MA",
"postal_code": "023461458",
"telephone_number": "508-923-3427",
"fax_number": "508-923-3428"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COSTA",
"first_name": "KRISTEN",
"middle_name": "LEE",
"name_prefix": "Ms.",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "112239",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7009847",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "494574",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "PO8602",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Middleboro, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.