Active NPI
Madeleine Lucille Flynn, LCSW
- Clinical Social Worker
- Plymouth, MA
National Provider Identifier
1497769996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 101130
- 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
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 | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P2228801 | Other | MA | MEDICARE 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.