Active NPI
Maureen Doherty, LICSW
- Clinical Social Worker
- Boston, MA
National Provider Identifier
1609366814
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 115757
- Practice address
- 110 Francis St
Boston, MA 02215-5501 - Phone
- (617) 632-9832
- Fax
- (617) 632-9833
- NPI assigned
- May 14, 2018
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 115757 | MA | Primary |
Addresses
Primary practice location
110 Francis St
Boston, MA 02215-5501
Mailing address
35 Cottage Rd
West Roxbury, MA 02132-5606
Phone (973) 342-2481
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 |
|---|---|---|---|
| 115757 | MA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blue Square Counseling and Wellness Center, PLLC | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526256000000",
"number": "1609366814",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 COTTAGE RD",
"city": "WEST ROXBURY",
"state": "MA",
"postal_code": "021325606",
"telephone_number": "973-342-2481"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 FRANCIS ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "022155501",
"telephone_number": "617-632-9832",
"fax_number": "617-632-9833"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOHERTY",
"first_name": "MAUREEN",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-14",
"last_updated": "2018-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "115757",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.