Individual provider Active NPI

Emma Avish

  • Clinical Social Worker
  • Brighton, MA
National Provider Identifier
1659928216
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LICSW126844 Issued in MA
Practice address
1660 Soldiers Field Rd Ste 7
Brighton, MA 02135-1108
Phone
(857) 301-7102
NPI assigned
Aug 19, 2019
Last updated
Mar 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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 LICSW126844 MA Primary

Addresses

Primary practice location

1660 Soldiers Field Rd Ste 7
Brighton, MA 02135-1108

Mailing address

1660 Soldiers Field Rd Ste 7
Brighton, MA 02135-1108

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
I20250618002537 MA Practitioner - Clinical Social Worker 9133630866 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LICSW126844MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
SDH Wellness LLC Clinical CurrentSince May 12, 2025 Accepting new patients

Locations

1660 Soldiers Field Rd
Ste 7
Brighton, MA 02135
Phone (617) 302-6193

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1566172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1659928216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 SOLDIERS FIELD RD STE 7",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021351108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 SOLDIERS FIELD RD STE 7",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021351108",
            "telephone_number": "857-301-7102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVISH",
        "first_name": "EMMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-19",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "LICSW126844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MA

Sources for this page

Verify at the official NPI Registry.