Individual provider Active NPI

Donna Rose Prezzano, LICSW

  • Clinical Social Worker
  • Beverly, MA
National Provider Identifier
1740420785
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
115811 Issued in MA
Practice address
100 Cummings Ctr Ste 329C
Beverly, MA 01915-6123
Phone
(978) 491-0638
Fax
(978) 921-0044
NPI assigned
Mar 4, 2009
Last updated
Apr 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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 115811 MA Primary

Addresses

Primary practice location

100 Cummings Ctr Ste 329C
Beverly, MA 01915-6123

Mailing address

10 Woodbury St
Gloucester, MA 01930-1038
Phone (978) 491-0638

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
I20101104000371 MA Practitioner - Clinical Social Worker 6901090844 Practice locations: Beverly, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

100 Cummings Ctr
Suite 430G
Beverly, MA 01915-6500
Phone (978) 491-0638

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Hospital Corporation PastSince Jul 21, 2010 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1236124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1740420785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 WOODBURY ST",
            "city": "GLOUCESTER",
            "state": "MA",
            "postal_code": "019301038",
            "telephone_number": "978-491-0638",
            "fax_number": "978-921-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CUMMINGS CTR STE 329C",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156123",
            "telephone_number": "978-491-0638",
            "fax_number": "978-921-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREZZANO",
        "first_name": "DONNA",
        "middle_name": "ROSE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-04",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "115811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

Verify at the official NPI Registry.