Active NPI
Paul Staten
- Clinical Social Worker
- Haverhill, MA
National Provider Identifier
1578992269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1578992269
- Practice address
- 116 Summer St.
Haverhill, MA 01830-1118 - Phone
- (978) 373-7010
- NPI assigned
- Nov 4, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 1578992269 | MA | Primary |
Addresses
Primary practice location
116 Summer St.
Haverhill, MA 01830-1118
Mailing address
116 Summer St.
Haverhill, MA 01830-1118
Phone (978) 373-7010
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220723000064 | MA | Practitioner - Clinical Social Worker | 0446631303 | Practice locations: Amesbury, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2008
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
5 Market SQ
Suite 103
Amesbury, MA 01913-2440
Phone (978) 387-4076
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1578992269 | MA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A-4 Counseling | Clinical | Past | Accepting new patients |
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.
-
- Clinical Social Worker
- Amesbury, MA
- NPI 1417334376
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658448000000",
"number": "1578992269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "116 SUMMER ST.",
"city": "HAVERHILL",
"state": "MA",
"postal_code": "018301118",
"telephone_number": "978-373-7010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "116 SUMMER ST.",
"city": "HAVERHILL",
"state": "MA",
"postal_code": "018301118",
"telephone_number": "978-373-7010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STATEN",
"first_name": "PAUL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-11-04",
"last_updated": "2022-07-22",
"certification_date": "2022-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "1578992269",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Haverhill, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.