Individual provider Active NPI

Cherie M Gravelle-Stulsky, MSW

  • Clinical Social Worker
  • Hyannis, MA
National Provider Identifier
1578713004
Registry record updated Feb 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1019 Iyannough Rd
Hyannis, MA 02601-1839
Phone
(508) 778-1839
NPI assigned
Sep 20, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2015

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 Primary

Addresses

Primary practice location

1019 Iyannough Rd
Hyannis, MA 02601-1839

Mailing address

1019 Iyannough Rd
Hyannis, MA 02601-1839
Phone (508) 778-1839

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
I20201229002431 MA Practitioner - Clinical Social Worker 2961815444 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

39 A Industrial Park Rd
Plymouth, MA 02360-4868

PO Box
Suite 212
Centerville, MA 02632

PO Box
Suite 310
Marstons Mills, MA 02648-0310

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Health Services, LLC CurrentSince Dec 1, 2020 Accepting new patients
Emerald Meadow Counseling Clinical CurrentSince Jan 12, 2021 Accepting new patients

Locations

30 Taunton Grn
Ste 5
Taunton, MA 02780
Phone (508) 545-7400

411 Route 6A
Bldg 5
Yarmouth Port, MA 02675
Phone (508) 274-6986

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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": "1221868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423612800000",
    "number": "1578713004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 IYANNOUGH RD",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026011839",
            "telephone_number": "508-778-1839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 IYANNOUGH RD",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026011839",
            "telephone_number": "508-778-1839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVELLE-STULSKY",
        "first_name": "CHERIE",
        "middle_name": "M",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-20",
        "last_updated": "2015-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyannis, MA

Sources for this page

Verify at the official NPI Registry.