Individual provider Active NPI

Freddie Lauren Palmer

  • Clinical Social Worker
  • Newton Highlands, MA
National Provider Identifier
1710503438
Registry record updated Jan 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
123161 Issued in MA
Practice address
24 Lincoln St
Newton Highlands, MA 02461-1561
Phone
(508) 404-8467
NPI assigned
Jun 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2021

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 123161 MA Primary

Addresses

Primary practice location

24 Lincoln St
Newton Highlands, MA 02461-1561

Mailing address

PO Box 193
Wellfleet, MA 02667-0193
Phone (617) 943-7324

Other practice location 1

1286 Hyde Park Ave
Hyde Park, MA 02136-2714
Phone (857) 574-9824

Other identifiers 1

IdentifierTypeStateIssuer
1780202291MedicaidMA

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
123161MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1592438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610236800000",
    "number": "1710503438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 193",
            "city": "WELLFLEET",
            "state": "MA",
            "postal_code": "026670193",
            "telephone_number": "617-943-7324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 LINCOLN ST",
            "city": "NEWTON HIGHLANDS",
            "state": "MA",
            "postal_code": "024611561",
            "telephone_number": "508-404-8467"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1286 Hyde Park Ave",
            "address_purpose": "LOCATION",
            "city": "Hyde Park",
            "state": "MA",
            "postal_code": "021362714",
            "country_code": "US",
            "telephone_number": "857-574-9824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALMER",
        "first_name": "FREDDIE",
        "middle_name": "LAUREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-18",
        "last_updated": "2021-01-10",
        "certification_date": "2021-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "123161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780202291",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton Highlands, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2021; 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.