Individual provider Active NPI

Meeghan Mary Zervos, LICSW

  • Clinical Social Worker
  • Boston, MA
National Provider Identifier
1679825715
Registry record updated Apr 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
119092 Issued in MA
Practice address
15 Parkman St
Boston, MA 02114-3117
Phone
(617) 726-2636
NPI assigned
Oct 14, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 083250 NY
Clinical Social Worker 1041C0700X 119092 MA Primary

Addresses

Primary practice location

15 Parkman St
Boston, MA 02114-3117

Mailing address

30 Oliver St
Randolph, MA 02368-2026
Phone (631) 834-1668

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
I20151105001894 MA Practitioner - Clinical Social Worker 1052621901 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
083250NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Cove Human Services Inc CurrentSince Aug 17, 2015 Accepting new patients
Bay Cove Human Services, Inc Current Accepting new patients

Locations

66 Canal St
Boston, MA 02114
Phone (617) 371-3040

Organizations & group practices 2

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": "1350172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586390400000",
    "number": "1679825715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 OLIVER ST",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023682026",
            "telephone_number": "631-834-1668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 PARKMAN ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021143117",
            "telephone_number": "617-726-2636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZERVOS",
        "first_name": "MEEGHAN",
        "middle_name": "MARY",
        "name_prefix": "Miss",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-14",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "083250",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "119092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.