Individual provider Active NPI

Jade McGleughlin, LICSW

  • Clinical Social Worker
  • Cambridge, MA
National Provider Identifier
1629119573
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1017999 Issued in MA
Practice address
180 Pearl St
Cambridge, MA 02139-4014
Phone
(617) 876-2611
NPI assigned
Feb 12, 2007
Sex
Female
Sole proprietor
Yes

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 1017999 MA Primary

Addresses

Primary practice location

180 Pearl St
Cambridge, MA 02139-4014

Mailing address

180 Pearl St
Cambridge, MA 02139-4014
Phone (617) 876-2611

Other identifiers 1

IdentifierTypeStateIssuer
P05074OtherMAPROVIDER NUMBER

Other names 1

  • Julie McGleughlin Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 2, 2022 through Feb 2, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1017999MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629119573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 PEARL ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021394014",
            "telephone_number": "617-876-2611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 PEARL ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021394014",
            "telephone_number": "617-876-2611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGLEUGHLIN",
        "first_name": "JADE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1017999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "P05074",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "MCGLEUGHLIN",
            "credential": "LICSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.