Active NPI
Alexandra Wells, LICSW
- Clinical Social Worker
- Belmont, MA
National Provider Identifier
1609316124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 122523
- Practice address
- 115 Mill St
Belmont, MA 02478-1048 - Phone
- (617) 855-2805
- NPI assigned
- Mar 2, 2017
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| Clinical Social Worker | 1041C0700X | 223306 | MA | |
| Clinical Social Worker | 1041C0700X | 122523 | MA | Primary |
Addresses
Primary practice location
115 Mill St
Belmont, MA 02478-1048
Mailing address
115 Mill St
Belmont, MA 02478-1048
Phone (617) 855-2805
Other practice location 1
81 Huron Ave Apt 2
Cambridge, MA 02138-1454
Phone (508) 333-2854
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 122523 | Other | MA | LICSW LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 122523 | MA | MD | Clinical Social Worker |
| 223306 | MA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The McLean Hospital Corporation | Clinical | Current | Accepting new patients |
Locations
115 Mill St
Belmont, MA 02478
Phone (617) 855-2000
Interoperability endpoints
- wells.alexandra.mcl@direct.partners.masshiway.net
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597017600000",
"number": "1609316124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 MILL ST",
"city": "BELMONT",
"state": "MA",
"postal_code": "024781048",
"telephone_number": "617-855-2805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 MILL ST",
"city": "BELMONT",
"state": "MA",
"postal_code": "024781048",
"telephone_number": "617-855-2805"
}
],
"practiceLocations": [
{
"address_1": "81 Huron Ave Apt 2",
"address_purpose": "LOCATION",
"city": "Cambridge",
"state": "MA",
"postal_code": "021381454",
"country_code": "US",
"telephone_number": "508-333-2854",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WELLS",
"first_name": "ALEXANDRA",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-02",
"last_updated": "2020-08-10",
"certification_date": "2020-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "223306",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "122523",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICSW LICENSE",
"identifier": "122523",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Belmont, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.