Active NPI
Raquel Dalzon, LICSW
- Clinical Social Worker
- Saugus, MA
National Provider Identifier
1447526868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 118969
- Practice address
- 999 Broadway Ste 300
Saugus, MA 01906-4510 - Phone
- (617) 388-0450
- NPI assigned
- Mar 29, 2012
- 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 | 118969 | MA | Primary |
Addresses
Primary practice location
999 Broadway Ste 300
Saugus, MA 01906-4510
Mailing address
20 Maverick SQ
Boston, MA 02128-2335
Phone (617) 388-0450
Other practice location 1
22 Grant St
Lynn, MA 01902-2705
Phone (617) 388-0450
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 118969 | MA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Internal Medical Associates-Ebnhc | Current | Accepting new patients | |
| Neighborhealth Corporation | Current | Accepting new patients |
Locations
10 Grove St
East Boston, MA 02128
Phone (617) 569-5800
Organizations & group practices 2
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.
-
- Community Health Clinic/Center
- East Boston, MA
- NPI 1558481879
-
- Community Health Clinic/Center
- East Boston, MA
- NPI 1316994411
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717977600000",
"number": "1447526868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 MAVERICK SQ",
"city": "BOSTON",
"state": "MA",
"postal_code": "021282335",
"telephone_number": "617-388-0450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "999 BROADWAY STE 300",
"city": "SAUGUS",
"state": "MA",
"postal_code": "019064510",
"telephone_number": "617-388-0450"
}
],
"practiceLocations": [
{
"address_1": "22 Grant St",
"address_purpose": "LOCATION",
"city": "Lynn",
"state": "MA",
"postal_code": "019022705",
"country_code": "US",
"telephone_number": "617-388-0450",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DALZON",
"first_name": "RAQUEL",
"name_prefix": "Mrs.",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-03-29",
"last_updated": "2024-06-10",
"certification_date": "2024-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "118969",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saugus, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.