Individual provider Active NPI

Sandra Spadafora

  • Clinical Social Worker
  • Haverhill, MA
National Provider Identifier
1619104353
Registry record updated Jun 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
111797 Issued in MA
Practice address
86 Powder House Ave
Haverhill, MA 01830-6557
Phone
(978) 821-2810
NPI assigned
Jun 21, 2009
Last updated
Jun 21, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2009

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 111797 MA Primary

Addresses

Primary practice location

86 Powder House Ave
Haverhill, MA 01830-6557

Mailing address

86 Powder House Ave
Haverhill, MA 01830-6557
Phone (978) 821-2810

Other identifiers 1

IdentifierTypeStateIssuer
111797OtherMASOCIAL WORK LICENSE - LICSW

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
I20120206000097 MA Practitioner - Clinical Social Worker 9032376959 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hri Clinics, Inc.Group PAC ID 8022088483, 104 clinicians

Practice addresses (Care Compare)

116 Summer St
Haverhill, MA 01830-6032
Phone (978) 373-7010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
111797MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Arbour Elder Services, Inc. CurrentSince Nov 7, 2011 Accepting new patients
Hri Clinics, Inc. CurrentSince Nov 7, 2011 Accepting new patients
Arbour Elder Services, Inc. CurrentSince Nov 7, 2011 Accepting new patients
Hri Clinics Inc CurrentSince Nov 7, 2011 Accepting new patients

Locations

14 Fordham Rd
Boston, MA 02134
Phone (617) 783-9676

100 Ledgewood Pl
Ste 202
Rockland, MA 02370
Phone (781) 871-6500

Organizations & group practices 4

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": "1245542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245542400000",
    "number": "1619104353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 POWDER HOUSE AVE",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018306557",
            "telephone_number": "978-821-2810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 POWDER HOUSE AVE",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018306557",
            "telephone_number": "978-821-2810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPADAFORA",
        "first_name": "SANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-21",
        "last_updated": "2009-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "111797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL WORK LICENSE - LICSW",
            "identifier": "111797",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Haverhill, MA

Sources for this page

Verify at the official NPI Registry.