Individual provider Active NPI

Jennifer P McCarthy, LICSW

  • Social Worker
  • West Boylston, MA
National Provider Identifier
1609942457
Registry record updated Oct 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
1031803 Issued in MA
Practice address
47 Prospect St
West Boylston, MA 01583-1301
Phone
(508) 446-3786
Fax
(508) 835-4418
NPI assigned
Nov 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 1031803 MA Primary

Addresses

Primary practice location

47 Prospect St
West Boylston, MA 01583-1301

Mailing address

12 Shady LN
Holden, MA 01520-2584
Phone (508) 446-3786

Other identifiers 4

IdentifierTypeStateIssuer
470034OtherMATUSTS
PO7633OtherMABCBS
598282000OtherMAMAGELLAN
2175484OtherMACIGNA

Other names 1

  • Ms. Jennifer M Parry Former name

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
I20040309000781 MA Practitioner - Clinical Social Worker 3274421474 Practice locations: West Boylston, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

West Boylston, MA 01583
Phone (508) 446-3786

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1609942457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 SHADY LN",
            "city": "HOLDEN",
            "state": "MA",
            "postal_code": "015202584",
            "telephone_number": "508-446-3786",
            "fax_number": "508-835-4418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 PROSPECT ST",
            "city": "WEST BOYLSTON",
            "state": "MA",
            "postal_code": "015831301",
            "telephone_number": "508-446-3786",
            "fax_number": "508-835-4418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTHY",
        "first_name": "JENNIFER",
        "middle_name": "P",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-24",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "1031803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUSTS",
            "identifier": "470034",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "PO7633",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "598282000",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2175484",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "PARRY",
            "middle_name": "M",
            "prefix": "MS.",
            "credential": "LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in West Boylston, MA

Sources for this page

Verify at the official NPI Registry.