Active NPI
Jodie Anne Mullane, LICSW
- Social Worker
- Woburn, MA
National Provider Identifier
1598821381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 1016241
- Practice address
- 36 Commerce Way
Woburn, MA 01801 - Phone
- (781) 454-7974
- Fax
- (781) 938-1106
- NPI assigned
- Dec 28, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 1016241 | MA | Primary |
Addresses
Primary practice location
36 Commerce Way
Woburn, MA 01801
Mailing address
32 Lebanon Street
Winchester, MA 01890
Phone (781) 454-5974
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 468707 | Other | MAGELLAN | |
| P04746 | Other | BLUE CROSS BLUE SHIELD |
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 |
|---|---|---|---|---|
| I20060426000468 | MA | Practitioner - Clinical Social Worker | 0244240901 | Practice locations: Woburn, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
10 Cedar St
Woburn, MA 01801-6365
Phone (781) 454-5974
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1016241 | MA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1598821381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32 LEBANON STREET",
"city": "WINCHESTER",
"state": "MA",
"postal_code": "01890",
"telephone_number": "781-454-5974",
"fax_number": "781-938-1106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36 COMMERCE WAY",
"city": "WOBURN",
"state": "MA",
"postal_code": "01801",
"telephone_number": "781-454-7974",
"fax_number": "781-938-1106"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLANE",
"first_name": "JODIE",
"middle_name": "ANNE",
"name_prefix": "Mrs.",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MA",
"license": "1016241",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN",
"identifier": "468707",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "P04746",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Woburn, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.