Individual provider Active NPI

Mary V Tumavicus, LICSW

  • Clinical Social Worker
  • Attleboro, MA
National Provider Identifier
1750390167
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
107102 Issued in MA
Practice address
152 Emory St
Attleboro, MA 02703-2461
Phone
(508) 801-6606
Fax
(508) 222-5449
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 107102 MA Primary

Addresses

Primary practice location

152 Emory St
Attleboro, MA 02703-2461

Mailing address

PO Box 124
Mansfield, MA 02048-0124
Phone (508) 801-6606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, RI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050917000290 MA Practitioner - Clinical Social Worker 9436182623 Practice locations: Attleboro, MA
I20241230001686 RI Practitioner - Clinical Social Worker 9436182623 Practice locations: West Kingston, RI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

296 Fairgrounds Rd
West Kingston, RI 02892-1415
Phone (508) 801-6606

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
107102MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750390167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 124",
            "city": "MANSFIELD",
            "state": "MA",
            "postal_code": "020480124",
            "telephone_number": "508-801-6606",
            "fax_number": "508-222-5449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 EMORY ST",
            "city": "ATTLEBORO",
            "state": "MA",
            "postal_code": "027032461",
            "telephone_number": "508-801-6606",
            "fax_number": "508-222-5449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUMAVICUS",
        "first_name": "MARY",
        "middle_name": "V",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "107102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Attleboro, MA

Sources for this page

Verify at the official NPI Registry.