Active NPI
Mary Joan Peterson, LICSW
- Clinical Social Worker
- Wakefield, MA
National Provider Identifier
1750550356
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 113382
- Practice address
- 24 Bartley St
#4
Wakefield, MA 01880-3138 - Phone
- (617) 877-8108
- NPI assigned
- Feb 27, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 113382 | MA | Primary |
Addresses
Primary practice location
24 Bartley St
#4
Wakefield, MA 01880-3138
Mailing address
3 Butler Ave Unit 2
Maynard, MA 01754-1403
Phone (617) 877-8108
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1971
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
6 Essex Ctr Dr
Suite 107
Peabody, MA 01960-2910
Phone (978) 532-7588
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Compass2Goals LLC | Current | Accepting new patients | |
| C.a.R.E. LLC | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Health Service Psychologist
- Peabody, MA
- NPI 1093922742
-
- Social Worker
- Maynard, MA
- NPI 1952009722
-
- Adult Mental Health Clinic/Center
- Marshfield, MA
- NPI 1467571901
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676505600000",
"number": "1750550356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 BUTLER AVE UNIT 2",
"city": "MAYNARD",
"state": "MA",
"postal_code": "017541403",
"telephone_number": "617-877-8108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 BARTLEY ST",
"address_2": "#4",
"city": "WAKEFIELD",
"state": "MA",
"postal_code": "018803138",
"telephone_number": "617-877-8108"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "MARY JOAN",
"name_prefix": "Ms.",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-02-27",
"last_updated": "2023-02-16",
"certification_date": "2023-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "113382",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wakefield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.