Individual provider Active NPI

Monique Willett, LICSW

  • Clinical Social Worker
  • Manchester, NH
National Provider Identifier
1568512358
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3179 Issued in NH
Practice address
15 Nelson St FL 2
Manchester, NH 03103-2706
Phone
(603) 689-7890
NPI assigned
Jan 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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 3179 NH Primary

Addresses

Primary practice location

15 Nelson St FL 2
Manchester, NH 03103-2706

Mailing address

15 Nelson St FL 2
Manchester, NH 03103-2706
Phone (248) 229-1819

Other identifiers 1

IdentifierTypeStateIssuer
3434247MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140416000117 MA Practitioner - Clinical Social Worker 2860671476 Reassigns benefits to 2 organizations
I20241224000841 NH Practitioner - Clinical Social Worker 2860671476 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Counseling Center of Nashua IncGroup PAC ID 3274523758, 250 clinicians

Practice addresses (Care Compare)

15 Nelson St
FL 2
Manchester, NH 03103-2706
Phone (603) 883-0005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3179NHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Counseling Center of Nashua Inc Clinical CurrentSince Nov 19, 2024 Accepting new patients
Upham'S Corner Health Committee, Inc. CurrentSince Aug 7, 2023 Accepting new patients
Mount Auburn Hospital CurrentSince Feb 3, 2014 Accepting new patients
The Providence Center Past Accepting new patients
The Providence Center Inc Clinical Past Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

330 Mount Auburn St
Cambridge, MA 02138
Phone (617) 499-5054

415 Columbia Rd
Uphams Corner, MA 02125
Phone (617) 287-8000

500 Columbia Rd
Uphams Corner, MA 02125
Phone (617) 287-8000

24 Front St
Exeter, NH 03833
Phone (603) 772-3900

15 Nelson St
Ste 2
Manchester, NH 03103
Phone (603) 624-8491

Organizations & group practices 5

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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1568512358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 NELSON ST FL 2",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031032706",
            "telephone_number": "248-229-1819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 NELSON ST FL 2",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031032706",
            "telephone_number": "603-689-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLETT",
        "first_name": "MONIQUE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "3179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3434247",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.