Individual provider Active NPI

Ana Maya Wolf, LICSW

  • Clinical Social Worker
  • Pittsfield, MA
National Provider Identifier
1659448280
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
113354 Issued in MA
Practice address
333 East St
Brien Center
Pittsfield, MA 01201-5312
Phone
(413) 499-0412
Fax
(413) 499-0979
NPI assigned
Nov 29, 2006
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 113354 MA Primary

Addresses

Primary practice location

333 East St
Brien Center
Pittsfield, MA 01201-5312

Mailing address

PO Box 523
Stephentown, NY 12168-0523
Phone (518) 488-9755

Other identifiers 1

IdentifierTypeStateIssuer
37237OtherMAHEALTH NEW ENGLAND

Other names 1

  • Ana Luisa Burden Former name

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
I20070720000257 MA Practitioner - Clinical Social Worker 9739280728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

333 E St
Pittsfield, MA 01201-5369
Phone (413) 499-0412

334 Fenn St
Pittsfield, MA 01201-5286
Phone (413) 629-1062

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
113354MAMDClinical Social Worker

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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659448280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 523",
            "city": "STEPHENTOWN",
            "state": "NY",
            "postal_code": "121680523",
            "telephone_number": "518-488-9755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 EAST ST",
            "address_2": "BRIEN CENTER",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012015312",
            "telephone_number": "413-499-0412",
            "fax_number": "413-499-0979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "ANA",
        "middle_name": "MAYA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "113354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NEW ENGLAND",
            "identifier": "37237",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANA",
            "last_name": "BURDEN",
            "middle_name": "LUISA",
            "credential": "LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pittsfield, MA

Sources for this page

Verify at the official NPI Registry.