Individual provider Active NPI

Elizabeth M McDonnell, LICSW

  • Social Worker
  • Hyannis, MA
National Provider Identifier
1760762918
Registry record updated Aug 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
110593 Issued in MA
Practice address
460 West Main Street
Hyannis, MA 02601-3653
Phone
(508) 790-3375
Fax
(508) 790-3304
NPI assigned
Aug 19, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 110593 MA Primary

Addresses

Primary practice location

460 West Main Street
Hyannis, MA 02601-3653

Mailing address

460 West Main Street
Hyannis, MA 02601-3653
Phone (508) 790-3375

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
I20120209000054 MA Practitioner - Clinical Social Worker 0648437293 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Behavioral Health and Wellness Solutions of CT LLCGroup PAC ID 5395020945, 8 clinicians

Practice addresses (Care Compare)

24 Mayflower LN
Rochester, MA 02770-2136
Phone 20339960710

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
110593MAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health and Wellness Solutions of CT, LLC CurrentSince Mar 30, 2021 Accepting new patients

Locations

3013 Dixwell Ave
Hamden, CT 06518
Phone (203) 399-6071

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": "1313712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313712000000",
    "number": "1760762918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 WEST MAIN STREET",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026013653",
            "telephone_number": "508-790-3375",
            "fax_number": "508-790-3304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 WEST MAIN STREET",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026013653",
            "telephone_number": "508-790-3375",
            "fax_number": "508-790-3304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONNELL",
        "first_name": "ELIZABETH",
        "middle_name": "M",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-19",
        "last_updated": "2011-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "110593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyannis, MA

Sources for this page

Verify at the official NPI Registry.