Mary Shackelford Mumford, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1021698 Issued in MA

Practice address

1354 Hancock St
Quincy, MA 02169-5109

Phone

(617) 471-5686

NPI assigned

Aug 31, 2006

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730291246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 CHURCH ST",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020264315",
            "telephone_number": "781-686-9121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1354 HANCOCK ST",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021695109",
            "telephone_number": "617-471-5686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUMFORD",
        "first_name": "MARY",
        "middle_name": "SHACKELFORD",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1021698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "MU PO6400",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brenda Ann Mullins, M.ED.
• Michael Francis Mullins, M.ED.
• Multiple Sclerosis Specialty Center, LLC
• Ashenafi G. Mulu, PHARM.D
• Maura Mulvey
• Collin Murdock
• Virginia Grace Muron, M.A.
• Erin C Murphy, LICSW
• Jamei Murphy, APRN, NP-C, CWS
• Kelly A Murphy, MSW

• Clinical Social Worker in Quincy, MA
• Providers in Quincy, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.