Individual provider Active NPI

Madeleine Lucille Flynn, LCSW

  • Clinical Social Worker
  • Plymouth, MA
National Provider Identifier
1497769996
Registry record updated May 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
101130 Issued in MA
Practice address
28 Watercourse PL
Plymouth, MA 02360-3626
Phone
(781) 582-1087
Fax
(781) 585-6942
NPI assigned
Jul 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2016

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 101130 MA Primary

Addresses

Primary practice location

28 Watercourse PL
Plymouth, MA 02360-3626

Mailing address

28 Watercourse PL
Plymouth, MA 02360-3626
Phone (781) 582-1087

Other identifiers 1

IdentifierTypeStateIssuer
P2228801OtherMAMEDICARE PTAN

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

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463616000000",
    "number": "1497769996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 WATERCOURSE PL",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023603626",
            "telephone_number": "781-582-1087",
            "fax_number": "781-585-6942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 WATERCOURSE PL",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023603626",
            "telephone_number": "781-582-1087",
            "fax_number": "781-585-6942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLYNN",
        "first_name": "MADELEINE",
        "middle_name": "LUCILLE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2016-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "101130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "P2228801",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2016; 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.