Individual provider Active NPI

Maria Asselin Serrazina, MA, MSW,LICSW

  • Clinical Social Worker
  • Southbridge, MA
National Provider Identifier
1720145261
Registry record updated Jul 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
116835 Issued in MA
Practice address
52 Charlton St
Southbridge, MA 01550-1910
Phone
(508) 765-9101
Fax
(508) 764-4389
NPI assigned
Jan 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Clinical Social Worker 1041C0700X 116835 MA Primary

Addresses

Primary practice location

52 Charlton St
Southbridge, MA 01550-1910

Mailing address

140 Salli Cir
Ludlow, MA 01056-3232
Phone (413) 589-7660

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
116835MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374019200000",
    "number": "1720145261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 SALLI CIR",
            "city": "LUDLOW",
            "state": "MA",
            "postal_code": "010563232",
            "telephone_number": "413-589-7660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 CHARLTON ST",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "015501910",
            "telephone_number": "508-765-9101",
            "fax_number": "508-764-4389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRAZINA",
        "first_name": "MARIA",
        "middle_name": "ASSELIN",
        "name_prefix": "Mrs.",
        "credential": "MA, MSW,LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2013-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "116835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southbridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2013; 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.