Individual provider Active NPI

Alisa Delage, LICSW

  • Clinical Social Worker
  • Hingham, MA
National Provider Identifier
1639818073
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
124902 Issued in MA
Practice address
99 Derby St Ste 200
Hingham, MA 02043-4216
Phone
(508) 203-1727
NPI assigned
Jun 2, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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 124902 MA Primary

Addresses

Primary practice location

99 Derby St Ste 200
Hingham, MA 02043-4216

Mailing address

PO Box 835
Brockton, MA 02303-0835
Phone (508) 203-1727

Other identifiers 1

IdentifierTypeStateIssuer
124902OtherMALICSW

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
124902MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Harmony Within, LLC Clinical CurrentSince Oct 22, 2023 Accepting new patients

Locations

99 Derby St
Ste 200
Hingham, MA 02043
Phone (617) 356-0803

Organizations & group practices 1

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": "1654128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1639818073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 835",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023030835",
            "telephone_number": "508-203-1727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 DERBY ST STE 200",
            "city": "HINGHAM",
            "state": "MA",
            "postal_code": "020434216",
            "telephone_number": "508-203-1727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELAGE",
        "first_name": "ALISA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-02",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "124902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICSW",
            "identifier": "124902",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hingham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2023; 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.