Individual provider Active NPI

Dianne E.a. Yearwood, MSW, LICSW

  • Clinical Social Worker
  • Medford, MA
National Provider Identifier
1679050199
Registry record updated Jul 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
106029 Issued in MA
Practice address
50 Thomas St
Medford, MA 02155-4536
Phone
(781) 395-0131
NPI assigned
Jul 26, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2018

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 106029 MA Primary

Addresses

Primary practice location

50 Thomas St
Medford, MA 02155-4536

Mailing address

50 Thomas St
Medford, MA 02155-4536
Phone (781) 395-0131

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
106029MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1532563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532563200000",
    "number": "1679050199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 THOMAS ST",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554536",
            "telephone_number": "781-395-0131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 THOMAS ST",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554536",
            "telephone_number": "781-395-0131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEARWOOD",
        "first_name": "DIANNE",
        "middle_name": "E.A.",
        "name_prefix": "Ms.",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-26",
        "last_updated": "2018-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "106029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2018; 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.