Individual provider Active NPI

Michelle Ellen Keyworth, MSW, LICSW

  • Clinical Social Worker
  • Nashua, NH
National Provider Identifier
1639317407
Registry record updated Dec 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
15 Prospect St
Nashua, NH 03060
Phone
(603) 889-6147
Fax
(603) 594-9649
NPI assigned
Feb 1, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2012

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 Primary

Addresses

Primary practice location

15 Prospect St
Nashua, NH 03060

Mailing address

7 Prospect St
Nashua, NH 03060
Phone (603) 889-6147

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1687NHMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1233446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356566400000",
    "number": "1639317407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 PROSPECT ST",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "03060",
            "telephone_number": "603-889-6147",
            "fax_number": "603-594-9649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 PROSPECT ST",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "03060",
            "telephone_number": "603-889-6147",
            "fax_number": "603-594-9649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEYWORTH",
        "first_name": "MICHELLE",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-01",
        "last_updated": "2012-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashua, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.