Marjorie E Gagnon, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1024547 Issued in MA

Practice address

21 Everett Ave
Belchertown, MA 01007-9159

Phone

(413) 323-4773

Fax

(413) 323-7687

NPI assigned

Feb 28, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Holistic Healthcare Services, Inc.

  • Acupuncturist
  • Belchertown, MA
  • NPI 1245704733
  NPD (past)

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730217274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 426",
            "address_2": "48 A ST",
            "city": "WEST WARREN",
            "state": "MA",
            "postal_code": "010920426",
            "telephone_number": "413-436-5364",
            "fax_number": "413-436-5364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 EVERETT AVE",
            "city": "BELCHERTOWN",
            "state": "MA",
            "postal_code": "010079159",
            "telephone_number": "413-323-4773",
            "fax_number": "413-323-7687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNON",
        "first_name": "MARJORIE",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1024547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "P07463",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scott Forman, MD
• Foundation ABA
• Christopher J. Fox, PH.D.
• Joanna Gail Frame, O.D.
• Jason M Franconeri, MS, PA-C
• Silvia A Galvan, MD
• Tina-Lynn Gemme
• Marc H Gerstein, LIC. AC.
• Laura Irene Mazza Gonick, LMHC
• David Paul Gossman, ME.D

• Clinical Social Worker in Belchertown, MA
• Providers in Belchertown, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.