NPIMap

Individual provider Active NPI

A Gale Maynard, LICSW

  • Clinical Social Worker
  • Malden, MA
National Provider Identifier
1659469831
Registry record updated Nov 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1021697 Issued in MA
Practice address
389 Main St
Ste 303
Malden, MA 02148-5017
Phone
(781) 324-2381
Fax
(781) 388-1817
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2009

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 1021697 MA Primary

Addresses

Primary practice location

389 Main St
Ste 303
Malden, MA 02148-5017

Mailing address

389 Main St
Ste 303
Malden, MA 02148-5017
Phone (781) 324-2381

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

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Charitable Bureau of the Archdiocesse of Boston, Inc. Dba Past Accepting new patients
Catholic Charitable Bureau of the Archdiocese of Boston, Inc. PastSince Feb 17, 2004 Accepting new patients
The Counseling Center of Child Development, in Clinical Past Accepting new patients

Organizations & group practices 3

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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258070400000",
    "number": "1659469831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "389 MAIN ST",
            "address_2": "STE 303",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021485017",
            "telephone_number": "781-324-2381",
            "fax_number": "781-388-1817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "389 MAIN ST",
            "address_2": "STE 303",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021485017",
            "telephone_number": "781-324-2381",
            "fax_number": "781-388-1817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNARD",
        "first_name": "A",
        "middle_name": "GALE",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2009-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1021697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malden, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2009; 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.