Individual provider Active NPI

Cynthia Lynne Meeske, LICSW

  • Social Worker
  • Medway, MA
National Provider Identifier
1508917378
Registry record updated Apr 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
113248
Practice address
89 Main St Ste 304
Medway, MA 02053-1815
Phone
(774) 573-1644
Fax
(774) 233-0037
NPI assigned
Jan 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 113248 Primary

Addresses

Primary practice location

89 Main St Ste 304
Medway, MA 02053-1815

Mailing address

89 Main St Ste 304
Medway, MA 02053-1815
Phone (774) 573-1644

Other practice location 1

340 Maple St
Suite 400
Marlborough, MA 01752-3200
Phone (508) 485-9300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070321000153 MA Practitioner - Clinical Social Worker 2961505482 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

89 Main St
Suite 304
Medway, MA 02053-1815
Phone (774) 573-1644

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Red Phoenix Healing LLC CurrentSince Jul 1, 2010 Accepting new patients

Locations

770 Washington St
Ste 2A
Holliston, MA 01746
Phone (774) 573-1644

89 Main St
Ste 304
Medway, MA 02053
Phone (774) 573-1644

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.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555372800000",
    "number": "1508917378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 MAIN ST STE 304",
            "city": "MEDWAY",
            "state": "MA",
            "postal_code": "020531815",
            "telephone_number": "774-573-1644",
            "fax_number": "774-233-0037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 MAIN ST STE 304",
            "city": "MEDWAY",
            "state": "MA",
            "postal_code": "020531815",
            "telephone_number": "774-573-1644",
            "fax_number": "774-233-0037"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "340 Maple St",
            "address_2": "Suite 400",
            "address_purpose": "LOCATION",
            "city": "Marlborough",
            "state": "MA",
            "postal_code": "017523200",
            "country_code": "US",
            "telephone_number": "508-485-9300",
            "fax_number": "508-485-2106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEESKE",
        "first_name": "CYNTHIA",
        "middle_name": "LYNNE",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2019-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": "113248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medway, MA

Sources for this page

Verify at the official NPI Registry.