Individual provider Active NPI

Maria Teresa Anez Moronta, LICSW

  • Clinical Social Worker
  • Wakefield, MA
National Provider Identifier
1508346743
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
127925 Issued in MA
Practice address
14 Audubon Rd
Wakefield, MA 01880-1258
Phone
(904) 434-5979
NPI assigned
Aug 16, 2018
Last updated
Aug 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 104242-1 NY
Clinical Social Worker 1041C0700X 127925 MA Primary

Addresses

Primary practice location

14 Audubon Rd
Wakefield, MA 01880-1258

Mailing address

14 Audubon Rd
Wakefield, MA 01880-1258
Phone (904) 434-5979

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
104242-1NYMDSocial Worker
127925MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1534377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1508346743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 AUDUBON RD",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018801258",
            "telephone_number": "904-434-5979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 AUDUBON RD",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018801258",
            "telephone_number": "904-434-5979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANEZ MORONTA",
        "first_name": "MARIA TERESA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-16",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "104242-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "127925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wakefield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; 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.