Active NPI
Mary Fardy, LICSW
- Clinical Social Worker
- Bedford, MA
National Provider Identifier
1689611899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 113900
- Practice address
- 200 Springs Rd
(122)
Bedford, MA 01730-1114 - Phone
- (781) 687-2705
- Fax
- (781) 687-3305
- NPI assigned
- May 31, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 113900 | MA | Primary |
Addresses
Primary practice location
200 Springs Rd
(122)
Bedford, MA 01730-1114
Mailing address
200 Springs Rd
(122)
Bedford, MA 01730-1114
Phone (781) 687-2705
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315440000000",
"number": "1689611899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 SPRINGS RD",
"address_2": "(122)",
"city": "BEDFORD",
"state": "MA",
"postal_code": "017301114",
"telephone_number": "781-687-2705",
"fax_number": "781-687-3305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 SPRINGS RD",
"address_2": "(122)",
"city": "BEDFORD",
"state": "MA",
"postal_code": "017301114",
"telephone_number": "781-687-2705",
"fax_number": "781-687-3305"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARDY",
"first_name": "MARY",
"name_prefix": "Ms.",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-31",
"last_updated": "2011-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "113900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bedford, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.