Individual provider Active NPI

Erica B St. Germain, LICSW

  • Clinical Social Worker
  • Plymouth, MA
National Provider Identifier
1437418605
Registry record updated Nov 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
116860 Issued in MA
Practice address
124 Long Pond Rd Ste 11
Plymouth, MA 02360-2664
Phone
(508) 591-0149
NPI assigned
May 9, 2012
Last updated
Nov 1, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X 116860 MA Primary

Addresses

Primary practice location

124 Long Pond Rd Ste 11
Plymouth, MA 02360-2664

Mailing address

124 Long Pond Rd Ste 11
Plymouth, MA 02360-2664
Phone (508) 591-0149

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address estgermain@changingtidesplymouth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective May 1, 2026 through May 1, 2028

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

31 Home Depot Dr
Suite 231
Plymouth, MA 02360-2669

34 Main St Ext
Suite 103
Plymouth, MA 02360-3329

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
116860MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Plymouth County Behavioral Health LLC CurrentSince Jul 1, 2012 Accepting new patients

Locations

34 Main Street Ext
Ste 103
Plymouth, MA 02360
Phone (508) 830-0012

81 Samoset St
Plymouth, MA 02360
Phone (508) 747-0587

81 Samoset St
Ste 3
Plymouth, MA 02360
Phone (508) 830-0012

Interoperability endpoints

  • Direct secure messaging: estgermain@changingtidesplymouth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1336521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572566400000",
    "number": "1437418605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 LONG POND RD STE 11",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602664",
            "telephone_number": "508-591-0149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 LONG POND RD STE 11",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602664",
            "telephone_number": "508-591-0149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST. GERMAIN",
        "first_name": "ERICA",
        "middle_name": "B",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-09",
        "last_updated": "2019-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "116860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "estgermain@changingtidesplymouth.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "124 Long Pond Rd Ste 11",
            "city": "Plymouth",
            "state": "MA",
            "country_code": "US",
            "postal_code": "023602664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

Verify at the official NPI Registry.