Individual provider Active NPI

Tammy Marie Sheldon

  • Clinical Social Worker
  • Worcester, MA
National Provider Identifier
1730656331
Registry record updated Sep 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
125033 Issued in MA
Practice address
12 Queen St
Worcester, MA 01610-2411
Phone
(508) 860-1032
NPI assigned
Nov 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2022

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 125033 MA Primary

Addresses

Primary practice location

12 Queen St
Worcester, MA 01610-2411

Mailing address

12 Queen St
Worcester, MA 01610-2411
Phone (508) 860-1032

Other practice location 1

172 Lincoln St
Worcester, MA 01605-3750
Phone (508) 552-7363

Other identifiers 1

IdentifierTypeStateIssuer
110189259AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221114001536 MA Practitioner - Clinical Social Worker 0941677421 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
125033MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Healthlink, Inc. CurrentSince Oct 11, 2022 Accepting new patients
Community Healthlink Inc CurrentSince Oct 11, 2022 Accepting new patients

Locations

40 Spruce St
#2
Leominster, MA 01453
Phone (978) 534-6116

162 Chandler St
Worcester, MA 01609
Phone (508) 860-1080

72 Jaques Ave
Worcester, MA 01610
Phone (508) 860-1154

12 Queen St
Worcester, MA 01610
Phone (508) 860-1242

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1541030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1730656331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 QUEEN ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016102411",
            "telephone_number": "508-860-1032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 QUEEN ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016102411",
            "telephone_number": "508-860-1032"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "172 Lincoln St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016053750",
            "country_code": "US",
            "telephone_number": "508-552-7363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHELDON",
        "first_name": "TAMMY",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-01",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "125033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110189259A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.