Individual provider Active NPI

Maureen Kenny-Woodworth, LICSW

  • Clinical Social Worker
  • Wakefield, MA
National Provider Identifier
1518294412
Registry record updated Jul 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1030511 Issued in MA
Practice address
9 Foster St
Wakefield, MA 01880-2936
Phone
(781) 850-5535
Fax
(781) 246-8353
NPI assigned
Nov 12, 2009
Last updated
Jul 26, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2010

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 1030511 MA Primary

Addresses

Primary practice location

9 Foster St
Wakefield, MA 01880-2936

Mailing address

9 Foster St
Wakefield, MA 01880-2936
Phone (781) 850-5535

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
I20100216000379 MA Practitioner - Clinical Social Worker 1052455953 Practice locations: Wakefield, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

9 Foster St
Wakefield, MA 01880-2911

9 Foster St
Wakefield, MA 01880-2936
Phone (781) 850-5535

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1030511MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1257984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280102400000",
    "number": "1518294412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 FOSTER ST",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018802936",
            "telephone_number": "781-850-5535",
            "fax_number": "781-246-8353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 FOSTER ST",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018802936",
            "telephone_number": "781-850-5535",
            "fax_number": "781-246-8353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNY-WOODWORTH",
        "first_name": "MAUREEN",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-12",
        "last_updated": "2010-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1030511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wakefield, MA

Sources for this page

Verify at the official NPI Registry.