Active NPI
Mary Bobola, LICSW
- Social Worker
- Worcester, MA
National Provider Identifier
1477524254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 1026597
- Practice address
- 191 May St
Worcester, MA 01602 - Phone
- (508) 368-7888
- Fax
- (508) 792-4392
- NPI assigned
- Jan 30, 2006
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 1026597 | MA | Primary |
Addresses
Primary practice location
191 May St
Worcester, MA 01602
Mailing address
630 Plantation St
Worcester, MA 01605
Phone (508) 368-7888
Other identifiers 16
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1061933 | Other | CIGNA HEALTH PLAN | |
| 33824 | Other | FALLON COMMUNITY HEALTH P | |
| 2043637 | Other | FIRST HEALTH | |
| 042472266 | Other | PRIVATE HEALTHCARE SYSTEM | |
| 580244000 | Other | MAGELLAN BEHAVIORAL HEALT | |
| 800011108 | Other | RAILROAD MEDICARE | |
| P07209 | Other | BLUE SHIELD HMO BLUE | |
| 042472266 | Other | PACIFICARE | |
| 042472266 | Other | THREE RIVERS | |
| 785946 | Other | MVP HEALTH CARE | |
| P20253 | Other | MEDICARE B | |
| P07209 | Other | BLUE SHIELD INDEMNITY | |
| 042472266 | Other | HEALTHCARE VALUE MANAGEME | |
| P07209 | Other | BLUE CARE ELECT | |
| 04247226 | Other | ONE HEALTH PLAN | |
| 042472266006 | Other | TRICARE CHAMPUS |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1026597 | MA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reliant Medical Group, Inc | 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 and National Provider Directory roles.
-
- Family Medicine Physician
- Worcester, MA
- NPI 1720017528
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233273600000",
"number": "1477524254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 PLANTATION ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "01605",
"telephone_number": "508-368-7888",
"fax_number": "508-792-4392"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "191 MAY ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "01602",
"telephone_number": "508-368-7888",
"fax_number": "508-792-4392"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOBOLA",
"first_name": "MARY",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-30",
"last_updated": "2009-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MA",
"license": "1026597",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA HEALTH PLAN",
"identifier": "1061933",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FALLON COMMUNITY HEALTH P",
"identifier": "33824",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "2043637",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRIVATE HEALTHCARE SYSTEM",
"identifier": "042472266",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN BEHAVIORAL HEALT",
"identifier": "580244000",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "800011108",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD HMO BLUE",
"identifier": "P07209",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PACIFICARE",
"identifier": "042472266",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "THREE RIVERS",
"identifier": "042472266",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP HEALTH CARE",
"identifier": "785946",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE B",
"identifier": "P20253",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD INDEMNITY",
"identifier": "P07209",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHCARE VALUE MANAGEME",
"identifier": "042472266",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CARE ELECT",
"identifier": "P07209",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ONE HEALTH PLAN",
"identifier": "04247226",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE CHAMPUS",
"identifier": "042472266006",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.