Individual provider Active NPI

Raymond Charles Spinazola Jr., LICSW

  • Clinical Social Worker
  • Saugus, MA
National Provider Identifier
1477191674
Registry record updated Dec 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
000223497 Issued in MA
Practice address
1715 Broadway
Saugus, MA 01906-4703
Phone
(339) 227-2837
Fax
(781) 233-2931
NPI assigned
Dec 18, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2019

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 000223497 MA Primary

Addresses

Primary practice location

1715 Broadway
Saugus, MA 01906-4703

Mailing address

1715 Broadway
Saugus, MA 01906-4703
Phone (339) 227-2837

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
000223497MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1576627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576627200000",
    "number": "1477191674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 BROADWAY",
            "city": "SAUGUS",
            "state": "MA",
            "postal_code": "019064703",
            "telephone_number": "339-227-2837",
            "fax_number": "781-233-2931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 BROADWAY",
            "city": "SAUGUS",
            "state": "MA",
            "postal_code": "019064703",
            "telephone_number": "339-227-2837",
            "fax_number": "781-233-2931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPINAZOLA",
        "first_name": "RAYMOND",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-18",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "000223497",
            "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 Dec 18, 2019; 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.