Individual provider Active NPI

Jessica Mosey, LICSW

  • Clinical Social Worker
  • Waltham, MA
National Provider Identifier
1508345836
Registry record updated Aug 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
120662 Issued in MA
Practice address
333 Wyman St Ste 100
Waltham, MA 02451-1272
Phone
(978) 774-7566
NPI assigned
Aug 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2018

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 120662 MA Primary

Addresses

Primary practice location

333 Wyman St Ste 100
Waltham, MA 02451-1272

Mailing address

290 Nahatan St Apt 2
Norwood, MA 02062-2246
Phone (781) 413-6145

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 7, 2021 through Jul 7, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
120662MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1508345836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 NAHATAN ST APT 2",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020622246",
            "telephone_number": "781-413-6145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 WYMAN ST STE 100",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511272",
            "telephone_number": "978-774-7566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSEY",
        "first_name": "JESSICA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-08",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "120662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

Verify at the official NPI Registry.