Individual provider Active NPI

Gail M. Conley, L.I.C.S.W.

  • Clinical Social Worker
  • Holliston, MA
National Provider Identifier
1740352061
Registry record updated Mar 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1023453 Issued in MA
Practice address
838 Washington St
Holliston, MA 01746-3600
Phone
(508) 429-5558
NPI assigned
Nov 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2010

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 1023453 MA Primary

Addresses

Primary practice location

838 Washington St
Holliston, MA 01746-3600

Mailing address

838 Washington St
Holliston, MA 01746-3600
Phone (508) 429-5558

Other identifiers 2

IdentifierTypeStateIssuer
0000P08339OtherMABLUE CROSS BLUE SHIELD MA
9964-01OtherMAHARVARD PILGRIM

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
I20051006000846 MA Practitioner - Clinical Social Worker 5597780700 Reassigns benefits to 1 organization
Practice locations: Holliston, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

838 Washington St
Holliston, MA 01746-3600
Phone (508) 429-5558

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1023453MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Community Care, Inc. CurrentSince Feb 1, 2016 Accepting new patients

Locations

270 Bridge St
Ste 301
Dedham, MA 02026
Phone (617) 230-9905

190 Lenox St
Norwood, MA 02062
Phone (781) 769-8670

206 Milford St
Upton, MA 01568
Phone (508) 529-7000

Organizations & group practices 1

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269475200000",
    "number": "1740352061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "838 WASHINGTON ST",
            "city": "HOLLISTON",
            "state": "MA",
            "postal_code": "017463600",
            "telephone_number": "508-429-5558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "838 WASHINGTON ST",
            "city": "HOLLISTON",
            "state": "MA",
            "postal_code": "017463600",
            "telephone_number": "508-429-5558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONLEY",
        "first_name": "GAIL",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "L.I.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2010-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1023453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MA",
            "identifier": "0000P08339",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "9964-01",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holliston, MA

Sources for this page

Verify at the official NPI Registry.