Individual provider Active NPI

Selma Zelda Mirsky, L.I.C.S.W.

  • Clinical Social Worker
  • Needham, MA
National Provider Identifier
1598744401
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
PO1457 Issued in MA
Practice address
48 Marshall St
Needham, MA 02492-1940
Phone
(781) 444-4061
Fax
(781) 444-4061
NPI assigned
Jan 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PO1457 MA Primary

Addresses

Primary practice location

48 Marshall St
Needham, MA 02492-1940

Mailing address

48 Marshall St
Needham, MA 02492-1940
Phone (781) 444-4061

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
I20050916000835 MA Practitioner - Clinical Social Worker 5597798728 Practice locations: Newton Highlands, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1960
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

99 Needham St
Apt 1220
Newton Highlands, MA 02461-1641
Phone (617) 917-1865

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO1457MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598744401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 MARSHALL ST",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024921940",
            "telephone_number": "781-444-4061",
            "fax_number": "781-444-4061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 MARSHALL ST",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024921940",
            "telephone_number": "781-444-4061",
            "fax_number": "781-444-4061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRSKY",
        "first_name": "SELMA",
        "middle_name": "ZELDA",
        "name_prefix": "Mrs.",
        "credential": "L.I.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "PO1457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Needham, MA

Sources for this page

Verify at the official NPI Registry.