Thomas Mecsas-Faxon, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1021085 Issued in MA

Practice address

161 S Huntington Ave
Jamaica Plain, MA 02130-4885

Phone

(617) 264-5342

NPI assigned

Jan 29, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Thomas Faxon Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: thomasmecsasfaxon@ssmh.netsmartdirect.net

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.

• South Shore Mental Health Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Quincy, MA
  • NPI 1770528317
  NPD

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740326685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 S PLEASANT ST",
            "city": "SHARON",
            "state": "MA",
            "postal_code": "020671924",
            "telephone_number": "781-784-3631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 S HUNTINGTON AVE",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021304885",
            "telephone_number": "617-264-5342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MECSAS-FAXON",
        "first_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1021085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THOMAS",
            "last_name": "FAXON",
            "prefix": "MR.",
            "credential": "LICSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Brooke McMullen
• Jacqueline Yvette McNeil
• Moe McNeill
• Michael W McSweeney, CRNA
• Caleb McVey, FNP-BC
• Christopher John Medeiros, LMHC
• Kristen Elaine Medley, MD
• Alison Mehan
• Nisha Mehta, MSW
• Melissa Rocklen Licsw, LLC

• Clinical Social Worker in Jamaica Plain, MA
• Providers in Jamaica Plain, 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.