Heather Ayares, LICSW

Individual provider Active NPI Clinical Social Worker · Brookline, MA

NPI 1710107263 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1710107263
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
1024259 (MA)
Practice address
1101 Beacon St
Suite 8 West
Brookline, MA 02446-5587
Phone
(617) 694-2441
NPI assigned
Apr 26, 2007
Sex
Female
Sole proprietor
Yes

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

105 Glen Ave
Newton Center, MA 02459-2050
Phone (617) 694-2441

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20041117000972 MA Practitioner - Clinical Social Worker 4284698325 Practice locations: Newton Center, MA

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
1024259MAMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1024259 MA Yes

Addresses

Primary practice location

1101 Beacon St
Suite 8 West
Brookline, MA 02446-5587

Mailing address

105 Glen Ave
Newton, MA 02459-2050

Other identifiers

IdentifierTypeStateIssuer
PO7143OtherMABLUE CROSS BLUE SHIELD

Other providers in Brookline, MA

All providers in Brookline, MA · Clinical Social Worker in Massachusetts

Sources for this page

Verify at the official NPI Registry.