Maya B Hanelin, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

111522 Issued in MA

Practice address

930 Massachusetts Ave
Cambridge, MA 02139-3234

Phone

(617) 953-5835

NPI assigned

Feb 22, 2006

Last updated

Jul 3, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Dec 11, 2020 through Dec 11, 2026

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Massachusetts Institute of Technology

  dba MIT Health

  • Multi-Specialty Clinic/Center
  • Cambridge, MA
  • NPI 1346308723
  NPD (past)
• Riverside Community Care, Inc.

  • Community/Behavioral Health Agency
  • Norwood, MA
  • NPI 1780791467
  NPD (past)

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341273600000",
    "number": "1518932656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 MASSACHUSETTS AVE",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021393234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 MASSACHUSETTS AVE",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021393234",
            "telephone_number": "617-953-5835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANELIN",
        "first_name": "MAYA",
        "middle_name": "B",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-22",
        "last_updated": "2012-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "111522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "P08715",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crystal Han, M.D.
• Sunny Yeongseon Han
• Katherine Hanaway, MD
• Todd Handel, OPTICIAN
• James Handshaw Jr., PHARMD
• Claire Victoria Hanlon, PT, DPT
• Kenneth Hanlon Jr.
• Martin Hanlon
• Marina Hanna
• Leah Hannon, PA-C

• Clinical Social Worker in Cambridge, MA
• Providers in Cambridge, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.