Ellen Maiman, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1019793 Issued in MA

Practice address

111 Old Road to 9 Acre Cor
Concord, MA 01742-4141

Phone

(978) 369-1113

Fax

(978) 369-0908

NPI assigned

Feb 27, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Clinical Social Worker

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• My Health101 PC

  • Psychiatry Physician
  • Arlington, MA
  • NPI 1750760211
  NPD (past)

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598892986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 NADINE RD",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "017203619",
            "telephone_number": "978-266-1344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 OLD ROAD TO 9 ACRE COR",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017424141",
            "telephone_number": "978-369-1113",
            "fax_number": "978-369-0908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAIMAN",
        "first_name": "ELLEN",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1019793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "P10320",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "329229",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Mackos, CRNA
• Nora Maclellan, LCSW
• Jenna Ann Macri
• Dennis George Mahoney, MA CCC/SLP
• Laura Mahoney
• Gerald Oscar Malkin, DDS
• Paige Lauren Mallory, PHARMD
• Keri Manca, PA-C
• Kathryn Manfield, MSW
• Katherine Marcinkus, NP

• Clinical Social Worker in Concord, MA
• Providers in Concord, MA by specialty
• Clinical Social Worker in Massachusetts

• 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.

Verify at the official NPI Registry.