Individual provider Active NPI

Lucy Munson, LICSW

  • Clinical Social Worker
  • Waltham, MA
National Provider Identifier
1619020351
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
106149 Issued in MA
Practice address
77 Rumford Ave
Waltham, MA 02453-3872
Phone
(781) 894-4307
Fax
(781) 894-1195
NPI assigned
Jan 18, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 106149 MA Primary

Addresses

Primary practice location

77 Rumford Ave
Waltham, MA 02453-3872

Mailing address

77 Rumford Ave
Waltham, MA 02453-3872
Phone (781) 894-4307

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
I20070322000232 MA Practitioner - Clinical Social Worker 7810091329 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
106149MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Key Program, Incorporated. CurrentSince Sep 1, 2011 Accepting new patients
The Key Program, Incorporated. Clinical PastSince Nov 1, 2020 Accepting new patients

Locations

576 State St
Springfield, MA 01109
Phone (413) 781-6485

77 Rumford Ave
Waltham, MA 02453
Phone (781) 894-4307

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619020351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 RUMFORD AVE",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024533872",
            "telephone_number": "781-894-4307",
            "fax_number": "781-894-1195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 RUMFORD AVE",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024533872",
            "telephone_number": "781-894-4307",
            "fax_number": "781-894-1195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNSON",
        "first_name": "LUCY",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "106149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

Verify at the official NPI Registry.