Organization Active NPI

Lynn M Shoreman, Licsw, LLC

  • Clinical Social Worker
  • Salem, MA
National Provider Identifier
1720319197
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
113059 Issued in MA
Legal business name
LYNN M SHOREMAN, LICSW, LLC
Practice address
8 Front Street
Suite 216
Salem, MA 01970
Phone
(978) 219-9875
Fax
(978) 219-5029
NPI assigned
Jan 24, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Authorized official

Name
Ms. Lynn Shoreman, LICSW
Title
Owner, Clinician
Phone
(978) 219-9875

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 113059 MA Primary

Addresses

Primary practice location

8 Front Street
Suite 216
Salem, MA 01970

Mailing address

34 Ticehurst Lane
Marblehead, MA 01945
Phone (978) 219-9875

Other names 1

  • Lynn Mangiaracina, LICSW, LLC Former legal business name

National Provider Directory

National Provider Directory

Locations

8 Front St
Ste 216
Salem, MA 01970
Phone (978) 219-4713

NPI Registry JSON

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

{
    "created_epoch": "1264291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603756800000",
    "number": "1720319197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 TICEHURST LANE",
            "city": "MARBLEHEAD",
            "state": "MA",
            "postal_code": "01945",
            "telephone_number": "978-219-9875",
            "fax_number": "978-219-5029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 FRONT STREET",
            "address_2": "SUITE 216",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "01970",
            "telephone_number": "978-219-9875",
            "fax_number": "978-219-5029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYNN M SHOREMAN, LICSW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-24",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A",
        "authorized_official_last_name": "SHOREMAN",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "OWNER, CLINICIAN",
        "authorized_official_telephone_number": "978-219-9875",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "113059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lynn Mangiaracina, LICSW, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Salem, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; 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.