Amy S Kavadlo, LICSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

104863 Issued in MA

Practice address

1093 N Main St
Randolph, MA 02368-2100

Phone

(781) 963-7775

Fax

(781) 963-7776

NPI assigned

Dec 19, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Southeastern Psychiatric AssocGroup PAC ID 4486696614, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Southeastern Psychiatric Assoc

  • Psychiatry Physician
  • Randolph, MA
  • NPI 1891771267
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328054400000",
    "number": "1629054002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1093 N MAIN ST",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023682100",
            "telephone_number": "781-963-7775",
            "fax_number": "781-963-7776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1093 N MAIN ST",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023682100",
            "telephone_number": "781-963-7775",
            "fax_number": "781-963-7776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVADLO",
        "first_name": "AMY",
        "middle_name": "S",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-19",
        "last_updated": "2012-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "104863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chinenye U Kalu
• Daniel Kane, LICSW
• Michael A Kane
• Felicia Kanu
• Peter Karanja
• Krista Kavanagh
• Cassidy T Kearns
• Keene Consulting Agency, Inc.
• Kassandra Kehrer, BA
• Elisa L Kelley

• Social Worker in Randolph, MA
• Providers in Randolph, MA by specialty
• Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.