Individual provider Active NPI

Liam Joseph Connolly, LICSW

  • Clinical Social Worker
  • Jamaica Plain, MA
National Provider Identifier
1619154580
Registry record updated Jan 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
115475 Issued in MA
Practice address
150 S Huntington Ave
116B HCHV
Jamaica Plain, MA 02130-4817
Phone
(857) 364-2730
NPI assigned
Jan 23, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2013

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 115475 MA Primary

Addresses

Primary practice location

150 S Huntington Ave
116B HCHV
Jamaica Plain, MA 02130-4817

Mailing address

150 S Huntington Ave
116B HCHV
Jamaica Plain, MA 02130-4817
Phone (857) 364-2730

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

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": "1201046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357084800000",
    "number": "1619154580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 S HUNTINGTON AVE",
            "address_2": "116B HCHV",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021304817",
            "telephone_number": "857-364-2730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S HUNTINGTON AVE",
            "address_2": "116B HCHV",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021304817",
            "telephone_number": "857-364-2730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "LIAM",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-23",
        "last_updated": "2013-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "115475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica Plain, MA

Sources for this page

Verify at the official NPI Registry.