Individual provider Active NPI

Daniel H Owen, LICSW

  • Clinical Social Worker
  • Lynn, MA
National Provider Identifier
1619907680
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1021858 Issued in MA
Practice address
150 Market St FL 2
Lynn, MA 01901-1529
Phone
(781) 592-6100
Fax
(781) 592-1093
NPI assigned
Jul 4, 2006
Sex
Male
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 1021858 MA Primary

Addresses

Primary practice location

150 Market St FL 2
Lynn, MA 01901-1529

Mailing address

106 Thornton St
Revere, MA 02151-5105
Phone (781) 626-0978

Other identifiers 1

IdentifierTypeStateIssuer
1858319MedicaidMA

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
I20050726000705 MA Practitioner - Clinical Social Worker 5597792010 Practice locations: Lynn, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

150 Market St
Lynn, MA 01901-1529
Phone (781) 592-6100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1021858MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Central Square Therapy Associates Past Accepting new patients
Central Square Therapy Associates Clinical Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619907680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 THORNTON ST",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021515105",
            "telephone_number": "781-626-0978",
            "fax_number": "781-592-1093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MARKET ST FL 2",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011529",
            "telephone_number": "781-592-6100",
            "fax_number": "781-592-1093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWEN",
        "first_name": "DANIEL",
        "middle_name": "H",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1021858",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1858319",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynn, MA

Sources for this page

Verify at the official NPI Registry.