Individual provider Active NPI

Paulina Marie Heywood, MSW/LICSW

  • Clinical Social Worker
  • Roxbury, MA
National Provider Identifier
1609950336
Registry record updated Oct 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1017966 Issued in MA
Practice address
55 Dimock St
Roxbury, MA 02119-1029
Phone
(617) 442-8800
Fax
(617) 541-8622
NPI assigned
Oct 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1017966 MA Primary

Addresses

Primary practice location

55 Dimock St
Roxbury, MA 02119-1029

Mailing address

55 Dimock St
Roxbury, MA 02119-1029
Phone (617) 442-8800

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
I20050728000878 MA Practitioner - Clinical Social Worker 6103854443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Luminosity Behavioral HealthGroup PAC ID 7618137977, 4 clinicians

Practice addresses (Care Compare)

157 Main St
Brockton, MA 02301-4012
Phone (781) 344-0102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1017966MAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Luminosity Behavioral Health Services Inc CurrentSince May 9, 2012 Accepting new patients
Dimock Community Health Center Past Accepting new patients
Dimock Community Services Corp Past Accepting new patients
Dimock Community Services Corp Past Accepting new patients
Dimock Community Health Center, Inc Past Accepting new patients
Dimock Community Health Center Past Accepting new patients

Locations

157 Main St
Brockton, MA 02301
Phone (508) 559-1567

157 Main St
Ste 201
Brockton, MA 02301

810 Washington St
Ste 1
Stoughton, MA 02072

Organizations & group practices 6

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191542400000",
    "number": "1609950336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 DIMOCK ST",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021191029",
            "telephone_number": "617-442-8800",
            "fax_number": "617-541-8622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 DIMOCK ST",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021191029",
            "telephone_number": "617-442-8800",
            "fax_number": "617-541-8622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEYWOOD",
        "first_name": "PAULINA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MSW/LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1017966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roxbury, MA

Sources for this page

Verify at the official NPI Registry.